The Value of Preoperative CA 125 Levels in Prediction of Myometrial Invasion in Patients with Early-stage Endometrioid-type Endometrial Cancer

  • Atguden, Zeynep (Gynecology and Obstetrics Department, Akropol Medical Hospital) ;
  • Yildiz, Askin (Gynecology and Obstetrics Department, Ataturk Training and Research Hospital) ;
  • Aksut, Hayri (Gynecology and Obstetrics Department, Soma State Hospital) ;
  • Yalcin, Serenat Eris (Perinatology Department, Suleyman Demirel University) ;
  • Yalcin, Yakup (Gynecologic Oncology Department of Suleyman Demirel University) ;
  • Uysal, Dilek (Gynecology and Obstetrics Department, Ataturk Training and Research Hospital) ;
  • Yetimalar, Hakan (Oncology Department, Ataturk Training and Research Hospital)
  • Published : 2016.03.07


Aim: To evaluate the relationship between pre-operative CA-125 levels and myometrial invasion in patients with early-stage endometrioid-type endometrial cancer. Materials and Methods: Two-hundred and sixty patients were diagnosed with endometrial cancer between January 2007 and December 2012. Of these, 136 patients with stage 1 endometrioid histologic-type and documented pre-operative serum CA-125 levels were included in the study. Age, preoperative CA-125 level, histologic grade, surgical grade, and presence of deep myometrial invasion were recorded. Additionally, 16, 20, and 35 IU/ml cutoff values were used and compared to evaluate the relationship between pre-operative CA-125 levels and myometrial invasion. Results: The average serum CA-125 level was $35.4{\pm}36.7$ in patients with deep myometrial invasion, and $21.5{\pm}35.8$ in cases without deep myometrial invasion. The relationship between the presence of deep myometrial invasion and CA-125 cut-off values (16, 20, 35 IU/ml) was statistically significant, although the correlation was weak (p<0.05). When the relationship between 16, 20 and 35 IU/ml CA-125 cut-off values and the presence of deep myometrial invasion was studied, specifity and sensitivity values were identified as: 0.60-0.68 for 16 IU/ml; 0.73-0.48 for 20 IU/ml; and 0.89-0.33 for 35 IU/ml. The sensitivity of 16 IU/ml cut-off value was higher when compared to other values. Conclusions: This study demonstrates that preoperative serum CA-125 values maybe used as a predictive test in patients with early stage endometrioid-type endometrium cancer, and as a prognostic factor alone. Further studies should be conducted to identify different CA-125 cut-off values in patients with low risk endometrial cancer.


Endometrial cancer;deep myometrial invasion;CA-125;cut-off value


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