Abstract
Introduction: Ovarian cancer is ranked third most frequent female cancer in India. The incidence varies between 2. 2 to 7. 8 per lakh population in various parts of India and there is steady increase in age standardized incidence rate of ovarian carcinoma.1 The present study was aimed to evaluate the histomorphology of epithelial ovarian tumors and to find the relationship between serum CA-125 levels with histopathology and staging of these neoplasms.
Material & Methods: 105 cases of surface epithelial ovarian tumors were evaluated over a period of one year from July 2018 to June 2019 in the Department of Pathology I.G.M.C Shimla. Preoperative serum CA125 levels were noted .Malignant tumors were staged using FIGO staging.
Results: Serous tumors were the most common tumors reported in the study constituting 67 cases (63.8%). Benign tumors (64.76%) comprised the major group followed by malignant tumors (29.52%) and borderline tumors (5.7%).. Serum CA125 concentration in benign, borderline and malignant tumors were compared and statistically significant difference was found (p=0.000). CA125 showed positive correlation with the stage (p=0.024) of ovarian cancer. However no significant correlation was found between subtype of benign, borderline and malignant tumors with serum CA125 levels.
Conclusion: Patients with borderline /malignant epithelial tumors had higher preoperative serum CA125 value as compared to benign ovarian tumors.
Keywords: surface epithelial ovarian tumors, serum CA125, age distribution, FIGO staging.
References
- Consolidated report of population based cancer registries 2012-2014. National cancer registry program Banglore ICMR. ncdirindia.org NCRP _Annual reports.
- Bast RC, Jr, Feeney M, Lazarus H, Nadler LM, Colvin RB, Knapp RC.Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest. 1981;68:1331–1337.
- Bast R, Klug T, St John E, et al. A radioummunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer. N Engl J Med. 1983;309(15):883-887.
- Jha R, Karki S. Histological pattern of ovarian tumors and their age distribution. Nepal Med Coll J. 2008; 10(2):81-85.
- Modepalli N, Venugopal SB. Clinicopathological Study of Surface Epithelial Tumours of the Ovary: An Institutional Study. Journal of Clinical and Diagnostic Research. 2016 Oct, Vol-10(10): EC01-EC04.
- Nageshwararao K, Srinivasarao C.” Ovarian surface epithelial tumor incidence in tertiary care hospital in Andhra Pradesh.”Iosr Journal of dental and Medical Sciences (IOSR-JDMS) 16.12(2017);16-20.
- Mankar DV, Jain GK. Histopathological profile of ovarian tumours: A twelve year institutional experience. Muller J Med Sci Res 2015;6:107-11.
- Tiwari RK, Saha K, Mukhopadhyay D, Datta C, Chatterjee U, Ghosh TK. Evaluation of preoperative serum levels of CA125 and expression of p53 in ovarian neoplasms: A prospective clinicopathological study in a tertiary care hospital. J Obstet Gynaecol India. 2016 Apr; 66(2):107-14.doi:10.1007/s13224-014-0611-7.Epub2014Oct7.
- Roy SK, Mandal K, Mandal K. Correlation between histopathological type and grade of different ovarian tumors with their blood CA125 levels. JMSCR, 2015; 3(2) : 4078-86
- Verma N, Kumar M, Sagar M, Babu S, Singhai A, Singh N, et al. Expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor type 2/neu in surface epithelial ovarian tumours and its clinicohistopathological correlation. Indian J Health Sci Biomed Res 2018;11:19-24.
- Pradhan A, Sinha AK, Upreti D. Histopathological spectrum of ovarian tumors at BPKIHS. Health Renaissance 2012;10(2):87-97.
- Kolwijick, E. et al. Preoperative CA-125 level in 123 patients with borderline ovarian tumors: a retrospective analysis and review of the literature. Int J Gynecol Cancer, v.19, n. 8, p. 1335-8, 2009.
- Cambruzzi E, Lima RD, Teixeira SL, Pegas KL. The relationship between serum levels of CA 125 and the degree of differentiation in ovarian neoplasms. J Bras Patol Med Lab, 2014;50(1):20-25.
- Atla B, Sarkar RN, Rasaputra M. Clinicopathological and IHC study (estrogen receptors, progesterone receptor, HER2/NEU) in malignant ovarian tumors. Int J Res Med Sci 2016;4: 1068-73.
- Vasquez FM, Pedernera E, Obregon JR, Lopez-Basave HN, Gomora MJ, Carlon E et al. High levels of pretreatment CA125 are associated to improved survival in high grade serous ovarian carcinoma. Journal of ovarian Research (2016); 9:41.
- Igor But, M.D., M.Sc.; Borut Gorišek, M.D., Ph.D. Preoperative Value of CA 125as a Reflection of Tumor Grade in Epithelial Ovarian Cancer gynecologic oncology November 1996 Volume 63, Issue 2, Pages 166–172 DOI: http://dx.doi.org/10.1006/gyno.1996.0301
- Osman N, O'Leary N, Higgins MJ, Barrett N, Wallis F, Hickey K, Gupta RK. Correlation of serum CA125 levels with stage, grade and survival of patients with epithelial ovarian cancer. Journal of Clinical Oncology. 2007 Jun 20;25 (18_suppl): 16066.
Corresponding Author
Dr Neelam Sharma
Professor, Department of Pathology, IGMC, Shimla, India