DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20182426

Clinico-pathological correlation of ovarian tumors and tumor like lesions with role of CA125 and HE4 as biomarkers for discrimination of benign and malignant ovarian tumors

Nidhi Verma, Vandana Tiwari, S. P. Sharma, Preeti Singh, Monika Rathi, Tushar Gupta

Abstract


Background: Ovarian tumors and tumor like lesions of ovary frequently form pelvic masses and are associated with hormonal manifestations. Clinically or surgically they can mimic malignancy but pathologically they could be benign tumors or tumor like lesions.

Methods: The aim of present study is to do clinico-histopathological correlation of ovarian tumors and tumor like lesions of ovary and also evaluate the role of serum CA125, HE4 and calculate risk of ovarian malignancy algorithm (ROMA), for differentiation of benign and malignant ovarian tumors.233 cases of ovarian tumors and tumor like lesions were studied. Tumors were classified according to WHO classification. Clinical and histological findings were compiled on proforma and subjected to analysis.

Results: In present study, out of total 233 cases, 41.2% were ovarian tumors and 58.8% tumor like lesions of ovary. Among tumor like lesions, follicular cyst was commonest lesion while among ovarian tumors, benign serous surface epithelial tumor was commonest. In patients with ovarian tumors, blood samples were collected, before and after the treatment for analysis of CA125, HE4 and ROMA.

Conclusions: Serum values of CA125and HE4 as well as ROMA were highly elevated in women with malignant epithelial tumors as compared to women with benign lesions. Also, all the parameters i.e. HE4, CA125 and ROMA showed significant difference before and after surgery. Hence measuring serum HE4 and CA125 along with ROMA calculation may provide higher accuracy for detecting malignant epithelial ovarian tumor.


Keywords


Clinico-histopathological, CA125, HE4, ROMA

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References


Kanthikar SN, Dravid NV, Deore PN, Nikumbh DB, Suryawanshi KH. Clinico-histopathological analysis of neoplastic and non-neoplastic lesions of the ovary: a 3-year prospective study in Dhule, North Maharashtra, India. JCDR. 2014 Aug;8(8):FC04.

Rosen DG, Wang L, Atkinson JN, Yu Y, Lu KH, Diamandis EP, et al. Potential markers that complement expression of CA125 in epithelial ovarian cancer. Gynecologic oncology. 2005 Nov 1;99(2):267-77.

Maggino T, Gadducci A, D'addario V, Pecorelli S, Lissoni A, Stella M, et al. Prospective multicenter study on CA 125 in postmenopausal pelvic masses. Gynecologic oncology. 1994 Aug 1;54(2):117-23.

Kobayashi H, Yamada Y, Sado T, Sakata M, Yoshida S, Kawaguchi R, et al. A randomized study of screening for ovarian cancer: a multicenter study in Japan. International J Gynecological Cancer. 2008 May 1;18(3):414-20.

Galgano MT, Hampton GM, Frierson HF. Comprehensive analysis of HE4 expression in normal and malignant human tissues. Mod Pathol. 2006;19:847-53.

Terlikowska KM, Dobrzycka B, Witkowska AM, Mackowiak-Matejczyk B, Sledziewski TK, Kinalski M, et al. Preoperative HE4, CA125 and ROMA in the differential diagnosis of benign and malignant adnexal masses. J ovarian research. 2016 Dec;9(1):43.

Nolen B, Velikokhatnaya L, Marrangoni A, De Geest K, Lomakin A, Bast RC, et al. Serum biomarker panels for the discrimination of benign from malignant cases in patients with an adnexal mass. Gynecologic oncology. 2010;117(3):440-5.

Moore RG, McMeekin DS, Brown AK, DiSilvestro P, Miller MC, Allard WJ, et al. A novel multiple marker bioassay utilizing HE4 and CA125 for the prediction of ovarian cancer in patients with a pelvic mass. Gynecologic oncology. 2009 Jan 1;112(1):40-6.

Pilli GS, Suneeta KP, Dhaded AV, Yenni VV. Ovarian tumours: a study of 282 cases. J Indian Medical Association. 2002 Jul;100(7):420-3.

Bodal VK, Jindal T, Bal MS, Bhagat R. A clinico -pathological study of ovarian lesions. RRJMHS. 2014;3(1).

Maheshwari V, Tyagi SP, Saxena K, Tyagi N, Sharma R, Aziz M, et al. Surface epithelial tumours of the ovary. Ind J Pathol Microbiol. 1994 Jan;37(1):75-85.

Gupta N, Bisht D, Agarwal AK, Sharma VK. Retrospective and prospective study of ovarian tumors and tumor-like lesions. Indian J Pathol Microbiol. 2007;50(3):525-27.

Misra RK, Sharma SP, Gupta U, Gaur R, Mishra SD. Pattern of ovarian neoplasm in eastern UP. J Obstet Gynecol India. 1991;30:242-46.

Prabhakar BR, Maingi K. Ovarian tumours-prevalence in Punjab. Indian J Pathol Microbiol. 1989;32(4):276-81.

Ramachandra G, Harilal KR, Chinnamma K, Thangavelu H. Ovarian neoplasms-A study of 903 cases. J Obstet Gynecol India. 1972;22:309-15.

Tyagi SP, Tyagi GK, Logani KB. A pathological study of 120 cases of ovarian tumours. J Obstet Gynecol India. 1967;17:423-33.

Couto F, Nadkarni NS, Rebello MJ. Ovarian tumors in Goa: A clinicopathological study. J Obstet Gynecol India. 1993;43:408-12.

Hamed EO, Ahmed H, Sedeek OB, Mohammed AM, Abd-Alla AA, Ghaffar HM. Significance of HE4 estimation in comparison with CA125 in diagnosis of ovarian cancer and assessment of treatment response. Diagnostic pathology. 2013 Dec;8(1):11.