Clinical Significance of Serum CA 125, CA 19-9 as Tumor Markers in Benign Ovarian Tumors

Choi, Jae Ho; Jin, Keon

Abstract

OBJECTIVE
This study was designed to determine the clinical significance of serum CA 125 and CA 19-9 levels in preoperative differential diagnosis of benign ovarian tumors.
METHODS
104 patients who visited the department of Obstetrics and Gynecology of Dankook University Hospital from February 1999 to December 2001, and who were diagnosed as adnexal mass and underwent surgery, and free of other medical diseases, were enrolled as subjects. An analysis of preoperative serum CA 125, CA 19-9 levels of patients was performed in correlation with the postoperative histologic diagnoses. The histologic diagnoses were grouped as mature cystic teratoma, endometrioma, mucinous cystadenoma, serous cystadenoma, benign cystic tumor group, adnexal inflammatory disease group. Study group was defined as endometrioma, adnexal inflammatory disease in CA 125, and mature cystic teratoma, endometrioma in CA 19-9, and the others were defined as control group. Statistical analysis with Chi square test was done on the number of cases who showed CA 125 or CA 19-9 increment over cut off value between study group and control group. Study group was compared with control group in the mean value of serum tumor marker level and the mean value of elevated serum tumor marker level over cut off value.
RESULTS
The number of cases who showed serum CA 125 increment over cut off value (35 U/ml) was significantly higher in endometrioma and adnexal inflammatory disease group (p<0.05), and the number of cases who showed serum CA 19-9 increment over cut off value (37 U/ml) was significantly higher in endometrioma and mature cystic teratoma group (p<0.05). The mean value of serum tumor marker level and the mean value of elevated serum tumor marker level over cut off value in those groups showed no significant difference in comparison with those of the other groups.
CONCLUSION
In this study, increment of CA 19-9 in endometrioma and CA 125 and CA 19-9 in mature cystic teratoma showed statistically significant higher frequency than other groups. We concluded that checking the preoperative serum level of CA 125 and CA 19-9, combined with transvaginal ultrasonography, may be helpful in differential diagnosis of benign ovarian tumors and in discriminating benign ovarian tumors from malignant ovarian tumors, if any other condition that may cause serum level elevation of CA 125 and CA 19-9 is excluded.