Clinical Significance Of Serum CA125,CA199 And CEA In Ovarian Clear Cell Carcinoma And Ovarian Endometrioid Carcinoma

Background: In the early stage of ovarian cancer,symptoms are hidden,diagnosis and treatment are difficult,and the malignant degree and mortality are high.Epithelial ovarian cancer(EOC)is the most common and a group of heterogeneous diseases with different morphology and biological behavior,while ovarian clear cell carcinoma(OCCC)and ovarian endometrial carcinoma(OEC)belong to EOC,which are related but different entities.In the clinical diagnosis and treatment process,serum tumor markers can be used as the basis to evaluate patients’ condition and make corresponding diagnosis and treatment plans.However,most studies on ovarian cancer tumor markers are not subtype-specific.Purpose: To explore the correlation between serum CA125,CA199 and CEA levels and positive rates of OCCC and OEC patients before operation and clinical indicators,and compare them with other types of epithelial ovarian cancer and endometriosis,so as to understand the diagnostic characteristics of OCCC and OEC,assist early diagnosis and reliable case classification diagnosis,and provide further reference for preoperative evaluation.Methods: A retrospective analysis was made on the concurrent surgical treatment in gynecology department of the First Affiliated Hospital of Dalian Medical University from January 2005 to January 2020.The patients were divided into OCCC group and OEC group according to the criteria of postoperative pathological diagnosis,and compared with other types of epithelial ovarian cancer group and endometriosis group.The clinical data and three tumor markers were collected and statistically analyzed by SPSS software.Result: 1.general information 72 OCCC cases and 38 OEC cases were included in this study.There were 49 cases of primary OCCC,34 cases of primary OEC,23 cases of OCCC and 4 cases of OEC combined with endometriosis.There are 221 cases of other common types of EOC,including 156 cases of ovarian serous carcinoma(OSC)(106 cases of High-grade serous carcinoma(HGSC),Low-grade serous carcinoma,(LGSC)),65 cases of ovarian mucinous carcinoma(OMC).122 cases of Endometriosis(EMs).2.Univariate analysis of serum levels of CA125,CA199 and CEA before operation and postoperative pathological types The levels of serum CA125,CA199 and CEA before operation were correlated with the pathological types of ovarian cancer.Compared with OCCC group,the preoperative serum CEA level in OEC group was higher,but the preoperative serum CA125 and CA199 levels in two groups had no statistical difference.The preoperative serum CA125 level in OCCC group was lower than that in HGSC and LGSC group and higher than that in OMC group.Serum CA199 level before operation was higher than HGSC group and LGSC group,but lower than OMC group.Serum CEA level before operation was lower than OMC group.The preoperative serum CA125 level in OEC group was lower than that in HGSC group and higher than that in OMC group.Serum CA199 level before operation was higher than that of HGSC group and LGSC group.Serum CEA level before operation was higher than LGSC group and lower than OMC group.Compared with EMs group,serum CA125 and CEA levels in OCCC group and OEC group were higher before operation.However,the difference of serum CA199 level before operation has no statistical significance.3.Univariate analysis of preoperative serum CA125,CA199 and CEA levels among clinical stage,tumor diameter and ascites volume in two types of ovarian cancer In OCCC group,preoperative serum CA125 was related to clinical stage and ascites volume,preoperative serum CA199 was related to tumor diameter,and preoperative serum CEA level had no significant difference in clinical stage,tumor diameter and ascites volume.In OEC group,preoperative serum CA125 was related to tumor diameter and ascites volume,while preoperative serum CA199 and CEA levels had no significant difference in clinical stage,tumor diameter and ascites volume.4.Univariate analysis of preoperative serum levels of CA125,CA199 and CEA with or without endometriosis The levels of serum CA125 and CEA in patients with endometriosis before operation were lower than those in patients without endometriosis(primary OCCC and primary OEC),and there was no significant difference in serum CA199 levels between the two groups before operation,suggesting that the higher the levels of CA125 and CEA before operation,the less likely it is to be complicated with endometriosis.The ratio of serum CA125 level > 200U/ml in patients with endometriosis before operation was lower than that in patients without endometriosis.5.ROC curves of preoperative serum CA125,CA199 and CEA levels in predicting positive ascites cytology in two types of ovarian cancer In OCCC group,the predictive value of preoperative serum CA125 for positive cytology and pathology of OCCC ascites was higher than CA199 and CEA.The most approximate index of calculated CA125 curve is 0.405,which is the best critical point,which indicates that preoperative serum CA125 is ≥ 96.965U/ml,and the accuracy of predicting positive cytology and pathology of OCCC ascites is high.In OEC group,it is suggested that three tumor markers have low accuracy and low predictive value in predicting OEC ascites cytology and pathology.6.Analysis of the relationship between preoperative serum CA125 level and FIGO clinical stage of two types of ovarian cancer It was found that serum CA125 level was positively correlated with FIGO stage in OCCC group,and the correlation degree was strong,suggesting that the higher serum CA125 level was,the later FIGO stage was.However,the preoperative serum CA125 level in OEC group had little correlation with FIGO stage.Conclusion: 1.Compared with OCCC patients,OEC patients had higher serum CEA level before operation.Serum CA125 levels were significantly increased in OSC patients before operation,and serum CA199 and CEA levels were significantly increased in OMC patients before operation.To provide reference for preoperative classification of ovarian cancer.2.The preoperative serum CA125 level of OCCC and OEC patients is related to the presence or absence of ascites and ascites volume,and the more ascites volume,the higher CA125 level.Serum CA125≥96.965U/ml before operation,and the accuracy of predicting positive cytology and pathology of OCCC ascites is high.3.The higher the preoperative serum CA199 level in OCCC patients indicates the larger tumor diameter,and the higher the preoperative serum CA125 level in OEC patients indicates the larger tumor diameter.4.There is a positive correlation between serum CA125 level and FIGO stage before OCCC,which suggests that the higher serum CA125 level is,the later FIGO stage is.5.The expression levels of serum CA125 and CEA in OCCC and OEC patients before operation were higher than those in endometriosis.The expression levels of serum CA125 and CEA in OCCC and OEC patients with endometriosis before operation were lower than those without endometriosis before operation,suggesting that the higher the levels of CA125 and CEA before operation,the less likely it is to be complicated with endometriosis.