Human seminal plasma analysis of five tumor markers: CA 125, alpha-fetoprotein, CA 50, CA 19.9, and CA 195.

OBJECTIVE: To evaluate tumor markers in seminal plasma and their possible relationship with fertility. METHODS: Five different tumor markers (alpha-fetoprotein, CA 125, CA 19.9, CA 50, and CA195) were studied in seminal plasma and serum from 42 males (14 volunteers from semen donation and 28 males from infertile couples). RESULTS: CA 50 and CA 19.9 levels were more than 300 times as high in seminal plasma as in serum (4,396.4 U/mL vs. 13.9 and 3,893.5 U/mL vs. 11.5). CA 125 levels were 14 times as high in seminal fluid as in serum (217.2 U/mL vs. 15.1), and CA 195 levels 22 times as high (122.5 U/mL vs. 5.6). alpha-Fetoprotein levels in seminal plasma were one-third those in serum (0.75 ng/mL vs. 2.47). Seminal levels of CA 125, CA 50, and CA 19.9 were correlated with the duration of infertility. Compared with donors, among seminal fluids from infertile couples there was a trend to higher levels of CA 19.9 and CA 125. CA 125 levels were lower in samples having normal sperm counts, and CA 125 and CA 19.9 levels were lower among couples who conceived compared with those who did not conceive. Tumor markers, either in seminal plasma or in serum, were not found to be correlated with semen characteristics. CONCLUSIONS: It appears that seminal levels of the tumor markers studied depend on more factors than the single serum concentration. The biological significance of the high seminal levels of the four carbohydrate antigens, and the association of low levels of CA 125 and CA 19.9 and fertility, could not be determined from our study. It is suggested, however, that CA 125 and CA 19.9 could be used as seminal plasma markers of fertility.

The role of second look laparotomy and tumor markers in the follow-up of endodermal sinus tumor of the ovary. A case report and review of the literature.

Endodermal sinus tumor (EST) of the ovary is extremely rare and little information exists about therapy and the role of second-look laparotomy in the management of this entity. A case of EST of the ovary in a 21 year old woman is reported. She received conservative surgery and six courses of combination therapy consisting of Vincristine, Actinomycin D and Cyclophosphamide before second-look laparotomy. Due to progression of the disease second-line polychemotherapy with Vinblastine, Bleomycin and Cisplatin was administered. This new regimen reduced the alpha-fetoprotein to normal levels although the patient was not free of disease on second-look laparotomy. Precise guidelines for the management of this disease, especially in advanced stages, are still lacking.