Aussagekraft der Tumormarker CA 125, CA 19-9, CA 15-3 und CEA bei Endometriose

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This study measured CA 125, CA 19-9, CA 15-3, and CEA in endometriosis patients before and after buserelin treatment, finding only CA 125 significantly decreased, reflecting ovarian function loss, not disease regression.

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The study measured serum tumor markers CA 125, CA 19-9, CA 15-3, and CEA in 42 women with histologically verified genital external endometriosis who received a 6-month course of the LHRH analogue buserelin. Pre-treatment sensitivity for detecting endometriosis was highest for CA 125 (49%) and low for CA 19-9 and CA 15-3 (both 19%), with CEA showing 0% sensitivity, and CA 125 had only a weak, nonconvincing correlation with AFS stage (r = 0.40); after treatment, marker–stage correlations were even less clear. Only CA 125 significantly decreased during therapy (p < 0.05), closely paralleling therapy-induced hypoestrogenism, and the authors conclude that measuring these markers cannot replace surgical/histologic diagnostic procedures. This paper is centrally about endometriosis—specifically evaluating the diagnostic and treatment-monitoring value of tumor markers (CA 125, CA 19-9, CA 15-3, CEA) in endometriosis.

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Abstract

CA 125, CA 19-9, CA 15-3 and CEA were measured in 42 patients with histologically verified endometriosis, who had been treated for six months by the LHRH-analogue buserelin (900 mcg/d intranasally). Before therapy, for all of the markers tested the sensitivity was as follows: CA 125 49%, CA 19-9 19%, CA 15-3 19% and CEA 0%. Pretherapeutically the correlation coefficient between CA 125 and the AFS stages was r = 0.40, indicating no significant relation. Following therapy the correlation between the tested glycoproteins and the AFS stages was less indicative. Only CA 125 showed a significant decrease during treatment (p less than 0.05), which paralleled the therapeutic hypo-oestrogenism. According to our results measurement of CA 125, CA 19-9, CA 15-3 and CEA is not sufficient to replace surgical procedures of monitoring endometriosis. The significant reduction of CA 125 apparently represents loss of ovarian function rather than regression of the disease.
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Subscribe to RSS DOI: 10.1055/s-2007-1026212 Aussagekraft der Tumormarker CA 125, CA 19-9, CA 15-3 und CEA bei Endometriose Diagnostic Significance of the Tumour Markers CA 125, CA 19-9, CA 15-3 and CEA in EndometriosisPublication History Publication Date: 18 March 2008 (online) Zusammenfassung Die Tumormarker CA 125, CA 19-9, CA 15- 3 und CEA wurden bei 42 Patientinnen gemessen, bei denen wegen einer histologisch gesicherten Endometriosis genitalis externa eine sechsmonatige Therapie mit dem LHRH-Analogon Buserelin (900 μg/d als Nasalspray) erforderlich wurde. Prätherapeutisch fand sich für die einzelnen Marker folgende Sensitivität: CA 125 49 %, CA 19-9 19%, CA 15-3 19% und CEA 0%. Vor der Behandlung ergab sich lediglich für CA 125 eine Korrelation von r = 0,40 zum AFS-Stadium, was keiner überzeugenden Abhängigkeit entspricht. Posttherapeutisch waren die Korrelationen zwischen Tumormarkern und Endometriosestadien noch weniger deutlich ausgeprägt. Lediglich Ca 125 zeigte als einziges der gemessenen Glykoproteine unter der Buserelintherapie einen signifikanten Abfall (p <0,05), der nahezu parallel zu der therapieinduzierten Östradiol-Suppression verlief. Nach den vorliegenden Ergebnissen ist die Bestimmung der Tumormarker CA 125, CA 19-9, CA 15-3 und CEA nicht geeignet, die operative Diagnostik mit histologischer Sicherung der Endometriose zu ersetzen. Vielmehr entspricht der unter der Behandlung aufgetretene signifikante Abfall von CA 125 eher dem Ruhen der Ovarialfunktion als einer therapieinduzierten Regression der Erkrankung. Abstract CA 125, CA 19-9, CA 15-3 and CEA were measured in 42 patients with histologically verified endometriosis, who had been treated for six months by the LHRH-analogue buserelin (900 mcg/d intranasally). Before therapy, for all of the markers tested the sensitivity was as follows: CA 125 49 %, CA 19-9 19 %, CA 15-319 % and CEA 0 %. Pretherapeutically the correlation coefficient between CA 125 and the AFS stages was r = 0.40, indicating no significant relation. Following therapy the correlation between the tested glycoproteins and the AFS stages was less indicative. Only CA 125 showed a significant decrease during treatment (p < 0.05), which paralleled the therapeutic hypo-oestrogenism. According to our results measurement of CA 125, CA 19-9, CA 15-3 and CEA is not sufficient to replace surgical procedures of monitoring endometriosis. The significant reduction of CA 125 apparently represents loss of ovarian function rather than regression of the disease.

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Condition tags

endometriosis

MeSH descriptors

Antigens, Tumor-Associated, Carbohydrate Biomarkers, Tumor Carcinoembryonic Antigen Endometriosis Genital Neoplasms, Female Adult Antigens, Tumor-Associated, Carbohydrate Biomarkers, Tumor Buserelin Buserelin Carcinoembryonic Antigen Endometriosis Endometriosis Female Follow-Up Studies Genital Neoplasms, Female Genital Neoplasms, Female Genital Neoplasms, Female Genital Neoplasms, Female Humans

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