The preoperative serum CA125 can predict the lymph node metastasis in endometrioid-type endometrial cancer
Abstract
Objectives: To evaluate the predictive value of preoperative CA125 in extra-uterine disease and its association with poor
prognostic factors in endometrioid-type endometrial cancer (EC).
Material and methods: A total of 423 patients with pathologically proven endometrioid-type EC were included in the
study. The association between preoperative CA125 level and surgical–pathological factors was evaluated. The conventional cut-off value was defined as 35 IU/mL.
Results: A high CA125 level ( > 35 IU/mL) was significantly associated with all of the studied poor prognostic factors,
except grade. The risk of lymph node metastasis (LNM) increased from 15.9% to 45.7% when CA125 level was > 35 IU/mL (p < 0.05). The optimal cut-off value for the prediction of LNM in patients aged > 50 years was determined to be 16 IU/mL (sensitivity, specificity, positive predictive value, and negative predictive value were 71%, 60%, 35%, and 87%, respectively.)
Conclusions: Preoperative CA125 level was significantly related with the extent of the disease and LNM. The age-dependent cut-off level of CA125 can improve the prediction of LNM in endometrioid-type EC. For older patients, CA125 level of > 16 IU/ml could be used to predict LNM. However, further studies are needed to evaluate the appropriate cut-off level of CA125 for younger patients.
Keywords: preoperative CA125endometrial cancerlymph node metastasespoor prognostic factors
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