Clinical significance of different serum tumor markers in gynecological malignancies.

The purpose of this study was to compare the diagnostic significance of serum tumor markers in patients with gynecological malignancies and to evaluate the usefulness of the markers in the follow-up after primary treatment. Determined were tissue polypeptide antigen (TPA), carcinoembryonic antigen (CEA), and phosphohexose isomerase (PHI). Serum samples from 200 patients with cervical cancer, 206 patients with endometrial cancer, and 254 patients with ovarian cancer were analyzed. With regard to specificity, CEA and PHI exhibited false positive rates below 10% in normal controls (N = 96). For TPA, the same result was obtained only by using 120 U/l as a cut-off level. As for sensitivity, positive rates above 50% prior to therapy were demonstrated by PHI and TPA in ovarian cancer as well as CEA in cervical cancer. All three tumor markers showed some decline in positiveness after primary therapy. In ovarian cancer the decline of PHI and TPA strongly correlates with the achievable tumor resection. During the follow-up, all markers demonstrated some discriminatory power by comparing patients with recurrent disease versus recurrence free. Especially PHI and TPA in ovarian cancer, CEA in cervical cancer, and PHI in endometrial cancer seem to be the most suitable markers.