JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
The role of preoperative serum CA-125 levels in predicting lymph node metastasis in patients undergoing treatment for endometrial cancer
Abstract
Aims: Endometrial cancer stands as the most prevalent gynecological malignancy in developed nations, often detected at an early stage, and generally carries a positive prognosis. The stage of the disease is important for survival, but many factors such as tumor grade, histopathology, myometrial invasion, age, and spread are also effective. Our objective was to assess the significance of preoperative Cancer antigen 125 (CA-125) concentrations in the prediction of lymph node metastasis in patients with endometrial cancer and to identify a suitable threshold value.
Methods: This retrospective analysis was carried out on 286 female patients diagnosed with endometrial cancer at a specialized gynecologic oncology facility from 2012 to 2022. We examined clinical-pathological and demographic attributes, including preoperative serum CA-125 concentrations, surgical interventions conducted for each patient, post-treatment physical assessments, imaging findings, and cytological outcomes. CA-125 was measured using electrochemiluminescence immunoassay.
Results: Statistically significant differences were observed in CA-125 levels among patients in terms of grade, invasion depth, lymph node involvement, cervical involvement, and stage (respectively, p<0.001, p=0.042, p<0.001, p<0.001, p<0.001). The FIGO advanced stage ratio was 30.6 times higher for serum CA-125 concentrations above the cutoff of 21 IU/ml (95% CI: 10.7-87.6) (p<0.001). Lymph node involvement was 29.7 times more likely for serum CA-125 values above the cutoff of 35 IU/ml (95% CI: 25.3-74.8) (p<0.001).
Conclusion: Early identification of high-risk endometrial cancer patients is vital for prognosis and guiding adjuvant therapy. CA-125, a tumor marker, has been found useful in assessing myometrial invasion depth, lymph node involvement, stage differentiation, and tumor grade.

Keywords : CA-125, endometrial cancer, metastasis, lymph node, predictive marker

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1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022.CA Cancer J Clin. 2022;72(1):7-33.
2. Makker V, MacKay H, Ray-Coquard I, et al. Endometrial cancer.Nature Rev Dis Primers. 2021;7(1):88.
3. Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E.Endometrial cancer. Lancet. 2016;387(10023):1094-1108.
4. Shawn LyBarger K, Miller HA, Frieboes HB. CA125 as a predictorof endometrial cancer lymphovascular space invasion and lymphnode metastasis for risk stratification in the preoperative setting.Sci Rep. 2022;12(1):19783.
5. Yilmaz Baran Ş, Alemdaroğlu S, Doğan Durdağ G, et al. What isthe predictive value of preoperative CA 125 level on the survivalrate of type 1 endometrial cancer? Turk J Med Sci. 2021;51(1):335-341.
6. Yin BWT, Lloyd KO. Molecular cloning of the CA125 ovariancancer antigen: identification as a new mucin, MUC16. J BiolChem. 2001;276(29):27371-27375.
7. Sahin F, Akt&uuml;rk E, G&uuml;nkaya OS, et al. Borderline ovarian tumors:twenty years of experience at a tertiary center. Anatolian Curr MedJ. 2023;5(3):196-200.
8. Muhammad S, Azwan RJ, Rita RS, Susanti R, Yusrawati. Therole of Interleukin 6 (IL6), Cancer Antigen-125 (CA-125), andHuman Epididymis Protein 4 (HE4) to predict tumor resectabilityin the advanced epithelial ovarian cancer patients. PLoS One.2023;18(10):e0292282.
9. Şahin F, Aydın E, &Ouml;cal EUB, &Ouml;zdemir S, Kasapoğlu AM, Akbayır&Ouml;. Evaluation of colposcopy and LEEP results performed ingynecology and gynecological oncology surgery services. Eur JGynaecological Oncol. 2024. doi:10.22514/ejgo.2023.071
10. Duk JM, Aalders JG, Fleuren GJ, de Bruijn HW. CA 125: auseful marker in endometrial carcinoma. Am J Obstet Gynecol.1986;155(5):1097-1102.
11. Reijnen C, Visser NC, Kasius JC, et al. Improved preoperativerisk stratification with CA-125 in low-grade endometrialcancer: a multicenter prospective cohort study. J Gynecol Oncol.2019;30(5):e70.
12. K&ouml;se O, &Uuml;nal O, K&ouml;se E, G&ouml;k K, Bostancı MS, &Ouml;zden S. Covid -19pandemisi &ouml;ncesi ve pandemi d&ouml;neminde endometrium kanserivakalarının karşılaştırılması bir eğitim araştırma hastanesi &ouml;rneği.Sakarya Tıp Derg. 2022;12(3):438-443.
13. Nithin KU, Sridhar MG, Srilatha K, Habebullah S. CA 125 is abetter marker to differentiate endometrial cancer and abnormaluterine bleeding. Afr Health Sci. 2018;18(4):972-978.
14. Markman M. The role of CA-125 in the management of ovariancancer. Oncologist. 1997;2(1):6-9.
15. Nicklin J, Janda M, Gebski V, Jobling T, Land R. The utility ofserum CA-125 in predicting extra-uterine disease in apparentearly-stage endometrial cancer. Int J Cancer. 2012;131(4):885-890.
16. Fu P, Sun H, Zhou T, Cui P, Wang S, Liu R. Postoperativeadjuvant treatment in women with stage I endometrial cancer:a retrospective study. Int J Clin Pract. 2023;2023:4007616. doi:10.1155/2023/4007616
17. Zhou X, Wang H, Wang X. Preoperative CA125 and fibrinogenin patients with endometrial cancer: a risk model for predictinglymphovascular space invasion. J Gynecol Oncol. 2017;28(2):e11.
18. Zamani N, Gilani MM, Mirmohammadkhani M, et al. The utilityof CA125 and HE4 in patients suffering from endometrial cancer.Int J Women&rsquo;s Health Reprod Sci. 2020;8(1):95-100.
19. Alcazar JL, Dominguez-Piriz J, Juez L, Caparros M, Jurado M.Intraoperative gross examination and intraoperative frozensection in patients with endometrial cancer for detecting deepmyometrial invasion: a systematic review and meta-analysis. IntJ Gynecol Cancer. 2016;26(2):407-415.
20. Kurt B, K&uuml;&ccedil;&uuml;kyıldız İ, Yanık A. The predictive role of CA- 125value in early stage endometrioid endometrial cancer. CumhuriyetMed J. 2023;45(2):31-37.
21. &Uuml;nsal M, Kimyon Comert G, Karalok A, Basaran D, TurkmenO. The preoperative serum CA125 can predict the lymph nodemetastasis in endometrioid-type endometrial cancer. GinekologiaPolska. 2018;89(11):599-606.
22. Schmidt M, Segev Y, Sadeh R, Suzan E, Feferkorn I, KaldawyA. Cancer antigen 125 levels are significantly associated withprognostic parameters in uterine papillary serous carcinoma. Int JGynecologic Cancer. 2018;28(7):1311-1317.
23. K&uuml;&ccedil;&uuml;kyıldız İ, Yanık A. The predictive role of CA-125 value inearly stage endometrioid endometrial cancer. Cumhuriyet Med J.2023;45(2):31-37.
24. Bağcı M, G&uuml;lhan İM, Saygılı U, Demir N. The diagnostic accuracyof magnetic resonance imaging in the prediction of myometrialinvasion and correlation between serum Ca - 125 level andmyometrial invasion in endometrial cancer. J Clin Obstet Gynecol.2005;15(6):296-303.
25. Atguden Z, Yildiz A, Aksut H, et al. The value of preoperative CA125 levels in prediction of myometrial invasion in patients withearly-stage endometrioid- type endometrial cancer. Asian Pac JCancer Prev. 2016;17(2):497-501.
26. Hsieh CH, Chang Chien CC, Lin H. Can a preoperative CA-125level he a criterion for full pelviclymphadenectomy in surgicalstaging of endometrial cancer? Gynecol Oncol. 2002;86(1):28-33.
27. Jiang T, Huang L, Zhang S. Preoperative serum CA125: a usefulmarker for surgical treatment of endometrial cancer. BMC Cancer.2015;15(1):1-8
28. Mitric C, Bernardini MQ. Endometrial cancer: transitioning fromhistology to genomics. Curr Oncol. 2022;29(2):741-757.
Article available in :
Volume 7, Issue 1, 2024
Page : 114-119
https://doi.org/10.32322/jhsm.1403151
Article Information
Received : 11 Ara 2023
Accepted : 08 Oca 2024
Published : 15 Oca 2024
Corresponding Author :

Fatih Şahin: Department of Obstetrics and Gynecology, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul, Turkey

[email protected]
Citation : Özdemir S, Şahin F, Doğan O, Kinter AK, Akbayır Ö. The role of preoperative serum CA-125 levels in predicting lymph node metastasis in patients undergoing treatment for endometrial cancer. J Health Sci Med. 2024;7(1):114-119.

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