Immunohistochemical Study of CA 125 in Surface Epithelial Tumors of Ovary in Correlation with Serum Levels
Keywords:
Ovarian cancer, CA 125, Immunohistochemistry, Cancer Antigen 125
Abstract
Background: Ovarian carcinoma is the 4th leading cancer among women in India. Primary ovarian neoplasms exhibit a wide range of histopathological patterns and tumors with epithelial differentiation are most frequent. Among malignant tumors, most common histological type is serous adenocarcinoma whose diagnosis is established in advanced stages of disease in approximately 75% of patients. The most widely used tumor marker in ovarian cancer, often considered “gold standard” is Cancer Antigen125. Cancer Antigen 125 is a high molecular weight glycoprotein which is raised in approximately 90% of patients with advanced epithelial ovarian cancer. Methods: A 2 year prospective study included 81 cases of ovarian neoplasms with surface epithelial differentiation. The specimens were fixed in 10% formalin, routinely processed. Sections of 4-5 microns thickness were obtained from the paraffin block and stained with Hematoxylin & Eosin. The tumors were categorised according to WHO classification. Immunohistochemical analysis of Cancer Antigen 125 was done in all malignant & borderline tumors. Result: A total of 81 cases were studied. There were 15 cases with elevated serum Cancer Antigen 125 levels. Of these 8 showed positive tissue expression. The sensitivity of serum Cancer Antigen 125 was 68.75% & its specificity was 93.8%. Conclusion: Serum Cancer Antigen 125 is elevated in ovarian tumors especially in malignant surface epithelial tumors & more commonly in serous cystadenocarcinoma. There was a good correlation between serum levels & tissue expression of Cancer Antigen 125.References
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2. Hogdall EV, Christensen L, Kjaer SK, Blaakaer J, Kjaerbye-Thygesen A, Gayther S, Jacobs I.J, Hogdall C.K. CA125: expression pattern, prognosis and correlation with serum CA125 in ovarian tumor patients: from the Danish “MALOVA” ovarian cancer study. Gynecol Oncol. 2007; 104:508–515.
3. Eduardo C, Lima R de, Luís TS, Lais PK. The relationship between serum levels of CA 125 and the degree of differentiation in ovarian neoplasms. J. Bras. Patol. Med. Lab. 2014 Feb; 50(1): 20-25.
4. Gupta D, Lis CG. Role of CA125 in predicting ovarian cancer survival-a review of the epidemiological literature. J Ovarian Res. 2009;2:13.
5. Devan SM, Pailoor J, Sthaneshwar P, Narayanan V. Pattern of tissue expression of CA-125 and HE4 in primary epithelial ovarian tumours and correlation with serum CA-125 levels. Asian Pac J Cancer Prev. 2013;14(8):4545–8.
6. Das C, Mukhopadhyay M, Ghosh T, Saha AK, Sengupta M. Correlation of Cytohistlogical Expression and Serum Level of Ca125 in Ovarian Neoplasm. Journal of Clinical and Diagnostic Research. 2014 Mar; Vol-8(3): 41-43.
7. Kriplani D, Patel MM.Immunohistochemistry: A diagnostic aid in differentiating primary epithelial ovarian tumors and tumors metastatic to the ovary. South AsianJ Cancer. 2013 Oct-Dec; 2(4): 254–258.
8. Scholler N, Urban N. CA 125 in Ovarian Cancer. Biomark Med. 2007 December;1(4): 513–523.
9. Ghartimagar D, Ghosh A, KC G , Ranabhat S, Talwar OP. Surface epithelial tumors of ovary - an analysis in a tertiary referral hospital. Journal of Pathology of Nepal.2013; Vol. 3: 397-402.
10. GG Swamy, N Satyanarayana. Clinicopathological analysis of ovarian tumors – A
study on five years samples. Nepal Med Coll J. 2010; 12(4): 221-223.
11. Pradhan A, Sinha AK, UpretiD.Histopathological patterns of ovarian tumors at
BPKIHS. HealthRenaissance.May-August 2012; Vol 10(No. 2): 87-97.
12. Bhagyalakshmi A, Sreelekha A, Sridevi S, Chandralekha J, Parvathi G, Venkatalakshmi A. Prospective study of histopathological patterns of ovarian tumours in a tertiary care centre. Int J Res Med Sci. 2014 May;2(2):448-456.
13. Mondal SK, Banyopadhyay R, Nag DR, Roychowdhury S, Mondal PK, Sinha SK.
Histologic pattern, bilaterality and clinical evaluation of 957 ovarian neoplasms: A10-year study in a tertiary hospital of eastern India. J Can Res Ther. 2011;7:433-7.
14. Wasim T, Majrroh A, Siddiq S. Comparison of clinical presentation of Benign and Malignant Ovarian Tumours. J Pak Med Assoc. 2009;59(1):18-21.
15. Ahmad Z, Kayani N, Hasan SH, Muzaffar S, Gill MS. Histopathological pattern of ovarian neoplasm. J Pak Med Assoc, 2000; 50: 416-9.
16. Ajani MA, Aramide KO, Salami A, Okolo CA. Histopathological pattern of Primary Ovarian Neoplasms in South Western Nigeria. Jos Journal of Medicine. July 2016; Vol 10(1): 1-8.
17. Meinhold-Heerlein I, Fotopoulou C, Harter P, Kurzeder C, Mustea A, Wimberger
P, et al. The new WHO classification of ovarian, fallopian tube, and primary peritoneal cancer and its clinical implications. Arch Gynecol Obstet. 2016 Jun;293(6):1367.
18. Mills SE, Greenson JK, Hornick JL, Longacre TA, Reuter VE. Sternberg‘s Diagnostic Surgical Pathology. 6th ed. Vol 2. China: Wolters Kluwer; 2015.p.2536-2613.
19. Tushar K, Asaranti K, Mohapatra PC. Intra-operative cytology of ovarian tumours.
J ObstetGynecol India. July/August 2005; Vol. 55(4):345-349.
20. Pravakar BRE, Maingi K. Ovarian tumours- Prevalence in Punjab- A study of 636
cases. Ind J Pathol Microbiol.1989; 32:276-81.
21. Einhorn N, Bast RC, Knapp RC, Tjernberg B, Zurawski VR. Preoperative Evaluation of Serum CA 125 Levels in Patients with Primary Epithelial Ovarian Cancer. Obstet Gynecol. 1986; 67(3): 414-416.
22. Morales-Vasquez F, Pedernera E, Obregon JR, Basave HNL, Gomora MJ, CarlonE, et al. High levels of pretreatment CA125 are associated to improved survival in
high grade serous ovarian carcinoma. J Ovarian Res. 2016; 9:41.
23. Bista KDB. Very High CA 125 due to Non-neoplastic Lesion of Ovary. NJOG.2012 Jul-Dec; 7(2):52-54.
24. Kolwijck E, Thomas CM, Bulten J, Massuger LFAG. Preoperative CA-125 levels in 123 patients with borderline ovarian tumors: a retrospective analysis and review of the literature. Int J Gynecol Cancer. 2009;19(8):1335-1338.
25. Thakur V, Anand AK, Mukherjee U, Ghosh D. Determination of Cancer Antigen 125 in Ovarian Carcinoma. Indian J of ClinBiochem. 2003; 18(2): 27-33.
26. O. Mogensen, B. Mogensen, A. Jakobsen, A. Sell. Preoperative Measurement of Cancer Antigen 125 (CA 125) in the Differential Diagnosis of Ovarian Tumors.Acta Oncologica. 1989; 28(4): 471-473.
27. Padhariya BB, Chavda J, Popat VC. Ca-125 Marker Study with Histological Correlation in Ovarian Tumor. IJAR. July 2015; Vol 5(7): 507-8.
28. Jacobs IJ, Skates S, Davies AP, WoolasRP, Jeyerajah A, Weidemann P. et al. Risk of diagnosis of ovarian cancer after raised serum CA 125 concentration: a prospective cohort study. Arch Iran med. 2010;13(3): 203-208.
Published
2020-07-30
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