Use of tumor markers to distinguish endometriosis‐related ovarian neoplasms from ovarian endometrioma. Issue 6 (June 2020)

• Record Type: Journal Article
• Authors: Shinmura, Hiroki; Yoneyama, Koichi; Harigane, Eika; Tsunoda, Yohei; Fukami, Takehiko; Matsushima, Takashi; Takeshita, Toshiyuki
• Is Part Of: International journal of gynecological cancer. Volume 30:Issue 6(2020)
• Publication Date: 2020-06
• Subjects: ovarian neoplasms -- ovarian cysts; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2020-001210
• Languages: English
• ISSNs: 1048-891X

Abstract

ABSTRACT : Objective : Only few studies have focused on tumor markers used in the preoperative diagnosis of endometriosis‐related ovarian neoplasms, and previous studies have only assessed serum CA125 levels. This study investigated the significance of preoperative tumor markers and clinical characteristics in distinguishing endometriosis‐related ovarian neoplasms from ovarian endometrioma. Methods : A case‐control study was conducted on 283 women who were diagnosed with confirmed pathology with endometriosis‐related ovarian neoplasms (n=21) and ovarian endometrioma (n=262) at a single institution from April 2008 to April 2018. The serum CA125, CA19‐9, carcinoembryogenic antigen (CEA), sialyl Lewis‐x antigen (SLX), and lactate dehydrogenase (LDH) levels, age, tumor size, and the presence of mural nodule of the patients were analyzed. Results : Patients with endometriosis‐related ovarian neoplasms were more likely to be older (48 (range, 26‐81) vs 39 (range, 22‐68) years, P<0.001), have higher levels of CA19‐9 (42 vs 19 U/mL, P=0.013), CEA (1.3 vs 0.84 ng/mL, P=0.007), SLX (41 vs 33 U/mL, P=0.050), and LDH (189 vs 166 U/mL, P<0.001) and larger tumor size (79 vs 55 mm, P=0.001), and present with mural nodule (85.7 vs 4.5 %, P<0.001) than those with ovarian endometrioma. The CA125 levels did not significantly differ between the two groups. The area under the curve for each factor was as follows: CA19‐9 level, 0.672 (95% CI 0.52 to 0.83; P=0.013); CEA level, 0.725 (95% CI 0.58 to 0.87; P=0.007); SLX level, 0.670 (95% CI 0.53 to 0.84; P=0.050); LDH level, 0.800 (95% CI 0.70 to 0.90; P<0.001); age, 0.775 (95% CI 0.65 to 0.90; P<0.001); and tumor size, 0.709 (95% CI 0.56 to 0.86; P=0.001). Age was a better marker than CA19‐9, CEA, and SLX levels according to the receiver operating characteristic curve analysis. The optimal cut‐off values for age and tumor size were 47 years and 80 mm, respectively. Conclusions : The assessment of serum CA19‐9, CEA, SLX, and LDH levels may be a useful tool in the preoperative evaluation to differentiate between endometriosis‐related ovarian neoplasms and ovarian endometrioma.