Preoperative cancer antigen 125 levels and its association with the stage and clinicopathological features of endometrial carcinoma, a retrospective study


Author(s): Jehan M. Al-Musawi* and Tlib H. Kamoona

Background: The role of preoperative cancer antigen 125 (CA-125) levels in predicting the behaviour of the tumour, its relation with the prognostic indicators of the patients and the optimal cut-off values is still controversial. Objective: This study aims to explore the role of preoperative CA-125 in predicting the prognostic parameters and aggressiveness of endometrial cancers and to define the best cut-off values. Patients and methods: It is a retrospective study involved the data of 53 eligible patients with endometrial cancer, who were admitted to the oncology teaching hospital in Baghdad during the period between January, 2018 and October, 2020. The patients’ clinical characteristics and tumour pathologic characteristics were compared with the preoperative CA-125 values using non parametric Mann-Whitney, Kruskal-Wallis, One-way ANOVA and Bonferroni post hoc analysis. The Receiver Operating Characteristic (ROC) curve was used to find the usefulness of the CA-125 test and the optimal cut-off values. Results: Preoperative CA-125 values showed a significant relationship with the pathologic characteristics of the tumour; including the grade, stage, histotype, lymphovascular space invasion and the extent of invasion, while they did not show a meaningful association with the clinical characteristics of the patients. Preoperative CA-125 test showed to be useful in predicting advanced disease with a level of 30.25 U/ml being the optimal cut-off value for deep myometrial invasion and extra-uterine disease with a sensitivity of 63.2% and 75%, respectively, and a specificity of 85.3% and 86.5%, respectively. On the other hand, the value of 44.6 U/ml was the best cut-off for lymph nodes metastasis with a sensitivity of 66.7% and a specificity of 85.4%. Conclusions: Elevated preoperative CA-125 showed to be helpful in predicting aggressive pathologic behaviour and extra-uterine disease in patients with apparently early stage tumours and it would help determining the extent of surgical staging and pattern of follow up in those patients.

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Awards Nomination

Editors List

  • Prof. Elhadi Miskeen

    Obstetrics and Gynaecology Faculty of Medicine, University of Bisha, Saudi Arabia

  • Ahmed Hussien Alshewered

    University of Basrah College of Medicine, Iraq

  • Sudhakar Tummala

    Department of Electronics and Communication Engineering SRM University – AP, Andhra Pradesh




  • Alphonse Laya

    Supervisor of Biochemistry Lab and PhD. students of Faculty of Science, Department of Chemistry and Department of Chemis


  • Fava Maria Giovanna


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