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CA 125, NB/70K, and Lipid-Associated Sialic Acid in Monitoring Uterine Papillary Serous Carcinoma

From the Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut

Abstract

Ninety-four plasma samples from 18 women with uterine papillary serous carcinoma were analyzed for three circulating tumor markers: CA 125, NB/70K, and lipid-associated sialic acid. Tumor marker values were correlated with the patients' clinical status. Preoperatively, CA 125, NB/70K, and lipid-associated sialic acid were elevated in 62, 64, and 67%, respectively. The distribution of clinical stages was I — 56%, 11 —%, 111 — 6%, and IV — 11%. The distribution of surgical stages was I — 28%, II — 17%, III — 0%, and IV —56%. Nine of ten patients with an elevated tumor marker had extrauterine disease confirmed surgically. Eight of nine patients with elevated levels of two markers had extrauterine disease. Four of four patients with three elevated markers had extrauterine disease. There were two false-positive elevations, both in patients who had occult surgical stage II disease. Rising and falling tumor marker levels correlated with progression and regression of disease, respectively. A doubling of CA 125 predicted clinical recurrence in four of six women an average of 17 weeks before clinical confirmation. Lipid-associated sialic acid levels that increased by 25% or by five units predicted recurrence or rapid progression in three of six patients in an average of 5 weeks, and a 50% elevation in NB/70K predicted recurrence in two of three patients by 5 and 3 weeks before clinical confirmation. Although the number of patients in this series is small, preoperative elevated tumor markers in patients known to have uterine papillary serous carcinoma correlate closely with the presence of extrauterine disease. This information should influence surgical management and may be useful in postsurgical treatment assessment.