CA 125 levels in the preoperative assessment of advanced-stage uterine cancer.

OBJECTIVE

The purpose of this study was too evaluate preoperative levels of CA 125 in for the prediction of advanced uterine cancer.

STUDY

DESIGN

We conducted a retrospective analysis of the correlation of preoperative CA 125 with grade, depth of invasion, lymph vascular space involvement, lymph node status, and stage.

RESULTS

High CA 125 levels correlated with advanced-stage (P <.0001) and positive (P <.0001) lymph node status. High levels of CA 125 also correlated with the deepest myometrial invasion, the presence of lymph vascular space involvement, and the highest grade. Receiver-operator characteristic curves demonstrated that depth of invasion, lymph vascular space involvement, and grade accurately predicted advanced-stage disease 73%, 77% and 80% of the time, respectively. CA 125 levels, however, correctly predicted advanced stage 94% of the time. The sensitivity and specificity of a CA 125 cutoff level of 37 IU/mL were 95% and 90%, respectively, with a positive predictive value of 78% and a negative predictive value of 97%.

CONCLUSION

CA 125 appears to be a significant independent predictor of positive lymph node status and the extrauterine spread of disease.