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. (Am J Obstet Gynecol 2003;188:1195-7.)