ABSTRACT

Objective

The aim of the present study was to evaluate the correlation between elevated preoperative CA 125 serum levels, the presence of tissue immunohistochemical staining of CA 125, and other pathological parameters in endometrial carcinoma.

Methods

Serum CA 125 levels were examined in 72 patients with endometrial cancer before definitive surgery and 20U/ml was used as cutoff value. After diagnosis was reconfirmated, additional 4-mm unstained slides were prepared from each cases for immunohistochemical staining. Immunohistochemical staining for CA 125 was assessed according to the ImmunoReactive Score.

Results

Statistical analyzes were performed to identify independent factor for high serum CA 125 levels, including CA 125 staining and the conventional pathologic features. Thirty-two of patients (44.4%) had an elevated CA 125 level (mean 126.83; range, 2.95-6442 U/ml). The percentage with positive CA 125 tissue staining (62/72, 86.1%) was significantly higher than the percentage with elevated serum levels (86.1% vs 44.4%, P=0.01). Thirty-two patients with elevated serum CA 125 levels had positive tissue staining (P=0.018), positive washing cytology (P=0.031) and lymphovascular invasion (LVI) (P=0.013) compared with patients with normal serum CA 125 levels. Multivariate analysis showed that elevated serum CA 125 significantly correlated with positive CA 125 tissue staining (P=0.045, OR: 3.2, 95% CI: 1.02-10.167) and positive CA 125 staining significantly related with deep myometrial invasion (P=0.02, OR: 6, 95%CI: 1.3-27.2).

Conclusions

We found that tissue CA 125 staining was an independent factor for high serum CA 125 levels at endometrial carcinoma.