The Efficacy of CA-125 and Tissue polypeptide specific antigen in Epithelial Ovarian Malignancy

Baek, Dong Hoon; Lee, Byoung Jae; Kim, Hwi Gon; Lee, Kwang Hyun; Kang, Joo Yeon; Han, Myoung Seok; Cha, Moon Seok

Abstract

PURPOSE
The purpose of this study is to examine the efficacy of CA-125 and tissue polypetide specific antigen(TPS) in patients with epithelial ovarian malignancy by comparing the two tumor markers in accordance with their measurement value at each stage of the disease, histological characteristics and changes in the measurement value before and after surgery.,ind during the period of chemotherapy. METHOD: We surveyed 22 patients with epithelial ovarian malignancy who were treated at Dong-A Univ. Medical Center between February 2001 and May 2002. Those patients were measured in terms of CA-125 and TPS before and after surgery. Out of them, especially, 11 patients under remission and 8 patients under progression received the blood sampling before and after chemotherapy and their blood samples were analyzed using immunoradiometric assay. RESULT: There were no significant differences in concentration of CA-125 and TPS according to the disease stages I, II and III(p=0.587). Sensitivity of CA-125 and TPS were measured 77.2% and 86.3%, respectively. The simultaneous use of TPS and CA-125 resulted in increased sensitivity, or 95.4%. From a histologicial view of epithelial ovarian malignancy, TPS was most sensitive to mutinous tumor and CA-125, serous tumor. TPS was significantly decreased from 190.2+/-164.1 U/I before surgery to 79.7+/-58.0 U/i after surgery(p=0.034). Similarly, CA-125 was significantly decreased from 292.2 +/-396.7 U/ml before surgery to 119.7+/-188.9 U/ml after surgery(p=0.034). In relation, it was stated that such decrease was more significant in TPS than in CA-125. During the 6 course of chemotherapy, 11 patients under the remission of epithelial ovarian malignancy showed significant decreases in concentration of TPS and CA-125 over time(TPS; p=0.032, CA-125;p=0.022). Another 8 patients under the progression of the disease showed significant increases in the two tumor markers(TPS;p=0.029, CA-125;p=0.042). For the former 11 patients, TPS lowered at a pace faster by 2 months than CA-125. Out of the latter, all showed increases in TPS more than normal and 6 patients in CA-125. CONCLUSION: There were no significant changes in concentration of CA-125 and TPS according to the stages of epithelial ovarian malignancy. The simultaneous use of the two tumor markers led to the increased sensitivity of diagnosis of the disease. TPS was most sensitive to mucinous tumor and CA-125, serous tumor. After surgery, TPS decreased significantly more than CA-125. Under chemotherapy, the progress of the disease was better reflected by TPS than by CA-125. Consequently, TPS is more effective in determining the course of epithelial ovarian malignancy than CA-125.