Akademik Veri Yönetim Sistemi
Nobel Medicus, cilt.6, sa.2, ss.75-78, 2010 (SCI-Expanded, Scopus)
• Objective: CA-125 is a mouse immunoglobulin 1 monoclonal antibody against the ovarian cancer cells and was first demonstrated by Bast. This is also a mucine like glycoprotein bigger than 200 000 Dalton. CA-125 is a tumor marker that helps clinicians in gynecology about the diagnosis and prognosis of the adnexial tumors. Increase in CA-125 is seen in endometriomas, ovarian inflamatory disease, and benign ovarian tumors like serous cystadenomas, as well as in non-gynecologic cancers like pancreas, colon, stomach, breast and pulmonaries. In patients with epithelial ovarian cancer, increased or decreased CA-125 levels have correlation with the activity of the disease in more than 90% of the patients. For differential diagnosis between benign and malign ovarian tumors and also for determination of the prognosis of the adnexial tumors, defining an ideal cut-off value is the objective of this research. • Material and Method: We examined the sensitivity, specificity, positive predictive and negative predictive value of CA-125 in patients with benign and malign ovarian tumors. In this retrospective study we took 168 patients whose CA-125 levels are known. Histopathologically malign lesions were detected in 30 patients, and benign lesions in 138 patients. CA-125 < 35 U/ml is accepted as normal level. Using numeric logistic system, we tried to find an ideal cut-off value for CA-125 to differentiate between benign and malign lesions. • Results: In malign ovarian cancers the average value of CA-125 was 183.344 (minimum 7.76, maximum value is 1032). The sensitivity of CA-125 in malign ovarian tumors, was 78.94%, specifity was 86.92%, positive predictive value was 63.82% and negative predictive value was 93.38%. • Conclusion: For differentiation of adnexial mass as benign or malign, CA-125 is found to be significant. But the sensitivity and specificity changed according to the estimated cut-off value of CA-125. When the cut-off value taken as 35 U/ml, then only 30 out of 38 cases could be labeled as malign. If the cut-off value is 65 U/ml, 25 of 38 malign cases are determined. The increase in specificity determines 124 benign cases instead of 113. If the cut-off is 35 U/ml, CA-125 gives one negative result for every 6 positive results.