The value of six tumor markers in preoperative diagnosis and prognostic evaluation of advanced serous ovarian cancer / 中国医师杂志

ABSTRACT

Objective:To explore the diagnostic and prognostic value of six tumor markers, namely carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), carbohydrate antigen 153 (CA153), carbohydrate antigen 199 (CA199), and carbohydrate antigen 724 (CA724), in the pathological types of epithelial ovarian cancer (EOC).Methods:A retrospective analysis was conducted on the preoperative tumor markers and clinical pathological data of 131 EOC patients admitted to the First Affiliated Hospital of Shihezi University from January 2010 to May 2022, and follow-up was conducted. Patients were divided into high-grade serous ovarian cancer (HGSOC) group and other groups (mucinous cancer, endometrioid carcinoma, clear cell carcinoma, mixed carcinoma) according to pathological type and tumor grade. We investigated the correlation between the levels of six tumor markers and the pathological types of EOC. By drawing receiver operating characteristic (ROC) curves and comparing the area under the curve (AUC), we also investigated the diagnostic value of single and combined detection of six tumor markers for the pathological types of EOC. K-M survival analysis was used to explore the impact of tumor markers on patient prognosis.Results:The levels of CA125 and CA153 in the HGSOC group were significantly higher than those in other pathological groups ( Z=-2.571, -5.416, all P<0.05); CA153 had good diagnostic performance for HGSOC (AUC=0.777), and the combined detection of CA125+ CA153, CA153+ AFP, CA153+ CA199, CA153+ CA724, CA153+ CE had better diagnostic performance than the single detection of CA125 and CA153 (AUC=0.781, 0.784, 0.809, 0.803, 0.773). Among them, the combined detection of CA125, CA153, and CA199 had the best diagnostic performance (AUC=0.816, Youden′s index 0.532); the elevated levels of CA153 and CA153+ CA199 indicated poor recurrence free survival (PFS) in patients (all P<0.05), while the elevated levels of CA153+ CA199 was an independent risk factor for recurrence in patients ( P=0.022); the elevated levels of CA153+ CA199 and CA125+ CA153+ CA199 indicated poorer OS in patients (all P<0.05). Conclusions:The serum levels of CA125 and CA153 are elevated in patients with HGSOC. Elevated levels of CA153, CA153+ CA199, and CA125+ CA153+ CA199 are associated with poor prognosis in patients. The combined detection of CA125, CA153, and CA199 has the best diagnostic efficacy and can serve as a potential biomarker for assisting in the diagnosis of HGSOC and evaluating patient prognosis.