Relationship between CA-125 Levels and Extrauterine Spread in Endometrial Cancer Endometrioid Type at Dr. Soetomo General Hospital Surabaya
Abstract
Background: Endometrial cancer is the sixth most common malignancy incidence in women worldwide. The surgical staging in endometrial cancer management such as bilateral salpingooophorectomy and lymphadenectomy is not a routine procedure for all endometrial cancer patients. Therefore, a biomarker to estimate the presence of endometrial cancer metastases to adnexa and lymph nodes is needed. This study aims to find out the level of cancer antigen 125 (CA-125) in endometrial cancer endometrioid type and the relationship between the level of CA-125 and the incidence of adnexal metastases, lymph node metastases, clinical stage, and myometrial invasion.
Methods: This observational analytic study used a direct observational design. The in-vitro quantitative examination was performed to measure CA-125 levels using CA-125 Advia Centaur CA-125 Kit. Fischer exact test used to analyzed CA-125 levels with the subject characteristics. All the statistical analyses were performed using SPSS v. 21.0.
Results: Of the 30 research subjects with the characteristics of the most age groups of 51–60 years (60%), with the most multiparous parity (73.3%), grade III (43.3%), myometrial invasion > 50% by 66.7%, early-stage (63.3%), the incidence of adnexal metastases (30%), and the incidence of lymph node (LN) metastases (10%), a significant relationship between CA-125 levels and lymph node (LN) metastases was found with a p = 0.041 and the phi association of 0.016 and between CA-125 levels and adnexal metastases with a p = 0.035 and the phi association of 0.026. There was also a significant relationship between CA-125 levels and the clinical stage (advanced stage) with p = 0.004 and the phi association of 0.002. There is no significant relationship with a p = 0.702 and a phi association value of -0.098.
Conclusions: CA-125 can be used as a tumor marker to predict the presence of extrauterine metastases (adnexa & lymph nodes).
Keywords
DOI: 10.33371/ijoc.v15i2.757
Article Metrics


References
American Cancer Society. Cancer Facts & Figures 2018 [Internet]. Atlanta: American Cancer Society; 2018 [cited 2021 Feb 18]. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-2018.pdf
Bereck JS, Hacker NF. Uterine Cancer. In: Elfrank JM, editor. Bereck & Hacker's Gynaecologic Oncology. 6th ed. Philadelphia: Walters Kluwer; 2015. p. 390-442.
Espino-Strebel EE, Luna JTP. Correlation between preoperative serum CA 125 and surgicopathologic prognostic factors in endometrial cancer. J Clin Oncol. 2012;27(15):
Sadowski EA, Robbins JB, Guite K, et al. Preoperative pelvic MRI and serum cancer antigen–125: Selecting women with grade 1 endometrial cancer for lymphadenectomy. AJR Am J Roentgenol. 2015;205(5):W556-64.
Ünsal M, Comert GK, Karalok A, et al. The preoperative serum CA125 can predict the lymph node metastasis in endometrioid-type endometrial cancer. Ginekol Pol. 2018;89(11):599-606.
Felder M, Kapur A, Gonzalez-Bosquet J, et al. MUC16 (CA125): tumor biomarker to cancer therapy, a work in progress. Mol Cancer. 2014;129(13):1-15.
Fares R, Kehoe S, Shams N. Preoperative prediction of lymph nodal metastases in endometrial carcinoma: is it possible?: A literature review. Int J Gynecol Cancer. 2018;28(2):394-400.
Jiang T, Huang L, Zhang S. Preoperative serum CA125: a useful marker for surgical management of endometrial cancer. BMC Cancer. 2015;15:396.
Sebastianelli A, Renaud M-C, Grégoire J, et al. Preoperative CA 125 tumour marker in endometrial cancer: Correlation with advanced stage disease. J Obstet Gynaecol Can. 2010;32(9):856-60.
Cao ZQ, Wang Z, Leng P. Aberrant N-cadherin expression in cancer. Biomed Pharmacother. 2019;118:109320.
Martinez-Rico C, Pincet F, Thiery JP, Dufour S. Integrins stimulate E-cadherin-mediated intercellular adhesion by regulating Src-kinase activation and actomyosin contractility. J Cell Sci. 2010;123:712-22.
Canel M, Serrels A, Frame MC, Brunton V. E-cadherin-integrin crosstalk in cancer invasion and metastasis. J Cell Sci. 2013;126:393–401.
Refbacks
- There are currently no refbacks.

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.