术前肿瘤标志物在预测子宫内膜癌术后病理组织学参数中有价值吗？

　　ARE PREOPERATIVE TUMOR MARKERS USEFUL IN PREDICTION OF POSTOPERATIVE HISTOPATHOLOGICAL PARAMETERS IN ENDOMETRIAL CANCER?

　　E. Baser, T. Gungor, C. Togrul, O. Turkoglu, S. Celen

　　Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey

　　Aims: To determine if preoperative serum CA125, CA15-3, CA19-9, AFP and CEA levels have an association with postoperative histopathological parameters in terms of tumor histology, grade, tumor size, cervical involvement, depth of myometrial invasion, lymphovascular involvement (LVSI), lymph node metastasis (LNM), positive peritoneal cytology, and peritoneal tumor involvement.

　　Methods: Data of 130 endometrial cancer (EC) cases treated between January 2008-January 2011 were retrospectively analyzed. Mann-Whitney U, one-way ANOVA tests and ROC curve analysis were utilized to determine the association between tumor markers and histopathological parameters.

　　Results: Levels of serum CA-125 and CA15-3 were associated with tumor histology, being significantly higher in non-endometrioid tumors (p=0.008). CA-125 levels were significantly higher in cases with LNM (p=0.001), positive peritoneal cytology (p=0.003) and peritoneal tumor involvement (p=0.03). CA-125 >80U/ml was highly predictive (sensitivity 75%, specificity 99%) for peritoneal tumor involvement (p=0.03). Serum tumor marker levels did not have a significant association with tumor size, depth of myometrial invasion, LVSI and cervical involvement (p>0.05).

　　[Table-1]

　　Conclusions: Preoperative prediction of histopathological factors indicating poor prognosis in EC is important for preoperative patient counselling, estimating the extent of the surgical procedure and anticipating adjuvant treatment. In this study, elevated levels of serum CA125 had a significant association with LNM, which is one of the most important prognostic variables. CA125 levels were also higher in non-endometrioid tumors, which generally have an unfavorable prognosis. Future studies assessing various serum markers and imaging techniques are needed to define an optimal test to preoperatively predict prognostic factors in EC.

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