Use of tumor markers to distinguish endometriosis-related ovarian neoplasms from ovarian endometrioma
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OBJECTIVE: Only few studies have focused on tumor markers used in the preoperative diagnosis of endometriosis-related ovarian neoplasms, and previous studies have only assessed serum CA125 levels. This study investigated the significance of preoperative tumor markers and clinical characteristics in distinguishing endometriosis-related ovarian neoplasms from ovarian endometrioma. METHODS: A case-control study was conducted on 283 women who were diagnosed with confirmed pathology with endometriosis-related ovarian neoplasms (n=21) and ovarian endometrioma (n=262) at a single institution from April 2008 to April 2018. The serum CA125, CA19-9, carcinoembryogenic antigen (CEA), sialyl Lewis-x antigen (SLX), and lactate dehydrogenase (LDH) levels, age, tumor size, and the presence of mural nodule of the patients were analyzed. RESULTS: Patients with endometriosis-related ovarian neoplasms were more likely to be older (48 (range, 26-81) vs 39 (range, 22-68) years, P<0.001), have higher levels of CA19-9 (42 vs 19 U/mL, P=0.013), CEA (1.3 vs 0.84 ng/mL, P=0.007), SLX (41 vs 33 U/mL, P=0.050), and LDH (189 vs 166 U/mL, P<0.001) and larger tumor size (79 vs 55 mm, P=0.001), and present with mural nodule (85.7 vs 4.5 %, P<0.001) than those with ovarian endometrioma. The CA125 levels did not significantly differ between the two groups. The area under the curve for each factor was as follows: CA19-9 level, 0.672 (95% CI 0.52 to 0.83; P=0.013); CEA level, 0.725 (95% CI 0.58 to 0.87; P=0.007); SLX level, 0.670 (95% CI 0.53 to 0.84; P=0.050); LDH level, 0.800 (95% CI 0.70 to 0.90; P<0.001); age, 0.775 (95% CI 0.65 to 0.90; P<0.001); and tumor size, 0.709 (95% CI 0.56 to 0.86; P=0.001). Age was a better marker than CA19-9, CEA, and SLX levels according to the receiver operating characteristic curve analysis. The optimal cut-off values for age and tumor size were 47 years and 80 mm, respectively. CONCLUSIONS: The assessment of serum CA19-9, CEA, SLX, and LDH levels may be a useful tool in the preoperative evaluation to differentiate between endometriosis-related ovarian neoplasms and ovarian endometrioma.
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A considerable increase in CA-125 concentrations may increase the suspicion of malignancy.
“Thus, a considerable increase in CA-125 concentrations may increase the suspicion of malignancy [20].”
From Clear cell carcinoma arising from abdominal wall endometriosis—A report on two cases and literature review (2022) · cites this paper as [20]
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Cites
ENDOMETRIAL CARCINOMA OF THE OVARY, ARISING IN ENDOMETRIAL TISSUE IN THAT ORGAN
SAMPSON, J. A. (1925) · Archives of Surgery · doi:10.1001/archsurg.1925.01120100007001 · Cited by 765 · see citing works
Malignant changes in endometriosis.
Rb, S. (1953) · PubMed · Cited by 290 · see citing works
Malkasian, G. D., KNAPP, R. C., Lavin, P. T., Zurawski, V. R., Podratz, K. C., Stanhope, C. R., Mortel, R., Berek, J. S., Bast, R. C., & Ritts, R. E. (1988) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(88)80081-4 · Cited by 225 · see citing works
Ayhan, A., Mao, T., Seckin, T. A., Wu, C., Guan, B., Ogawa, H., Futagami, M., Mizukami, H., Yokoyama, Y., Kurman, R. J., et al. (2012) · International Journal of Gynecological Cancer · doi:10.1097/igc.0b013e31826b5dcc · Cited by 166 · see citing works
Clear cell adenocarcinoma of the ovary: A clinical analysis and comparison with serous carcinoma
Jenison, E. L., MONTAG, A. G., Griffiths, C. T., Welch, W. R., Lavin, P. T., Greer, J., & KNAPP, R. C. (1989) · Gynecologic Oncology · doi:10.1016/0090-8258(89)90852-4 · Cited by 164 · see citing works
Endometrioid Adenocarcinoma of the Ovary and Its Relationship to Endometriosis
McMeekin, D. S., Burger, R. A., Manetta, A., DiSaia, P. J., & Berman, M. L. (1995) · Gynecologic Oncology · doi:10.1006/gyno.1995.1271 · Cited by 140 · see citing works
Pathogenesis and the Role of ARID1A Mutation in Endometriosis-related Ovarian Neoplasms
Maeda, D., & Shih, I. (2012) · Advances in Anatomic Pathology · doi:10.1097/pap.0b013e31827bc24d · Cited by 121 · see citing works
Malignant Transformation of Pelvic Endometriosis: MR Imaging Findings and Pathologic Correlation
Takeuchi, M., Matsuzaki, K., Uehara, H., & Nishitani, H. (2006) · Radiographics · doi:10.1148/rg.262055041 · Cited by 107 · see citing works
Vang, R., Gown, A. M., Barry, T. S., et al. (2005) · International Journal of Gynecological Pathology · doi:10.1097/01.pgp.0000177125.31046.fd · Cited by 102 · see citing works
Molecular profiling and molecular classification of endometrioid ovarian carcinomas
Cybulska, P., Paula, A. D. C., Tseng, J. H., Leitão, M. M., Bashashati, A., Huntsman, D. D., Nazeran, T. M., Aghajanian, C. A., Abu‐Rustum, N. R., DeLair, D. F., et al. (2019) · Gynecologic Oncology · doi:10.1016/j.ygyno.2019.07.012 · Cited by 101 · see citing works
Epithelial metaplastic changes in ovarian endometriosis.
Fukunaga, M., & Ushigome, S. (1998) · PubMed · Cited by 75 · see citing works
Clinical analysis of ovarian epithelial carcinoma with coexisting pelvic endometriosis
Wang, S., Qiu, L., Lang, J. H., Shen, K., Yang, J. X., Huang, H. F., Pan, L. Y., & Wu, M. P. (2012) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2012.12.004 · Cited by 73 · see citing works
Pathology of Endometrioid and Clear Cell Carcinoma of the Ovary
Fadare, O., & Parkash, V. (2019) · Surgical pathology clinics · doi:10.1016/j.path.2019.01.009 · Cited by 65 · see citing works
BAF250a Expression in Atypical Endometriosis and Endometriosis-Associated Ovarian Cancer
Stamp, J. P., Gilks, C. B., Wesseling, M., Eshragh, S., Ceballos, K. M., Anglesio, M. S., Kwon, J. S., Tone, A. A., Huntsman, D. D., & Carey, M. S. (2016) · International Journal of Gynecological Cancer · doi:10.1097/igc.0000000000000698 · Cited by 59 · see citing works
The Link Between Endometriosis and Ovarian Cancer
Nezhat, F. R., Pejovic, T., Reis, F. M., & Guo, S.-W. (2014) · International Journal of Gynecological Cancer · doi:10.1097/igc.0000000000000100 · Cited by 58 · see citing works
Pozzati, F., Moro, F., Pasciuto, T., Gallo, C., Ciccarone, F., Franchi, D., Mancari, R., Giunchi, S., Timmerman, D., Landolfo, C., et al. (2018) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.19171 · Cited by 58 · see citing works
Kim, K.-R., Choi, J., Hwang, J., et al. (2010) · Histopathology · doi:10.1111/j.1365-2559.2010.03673.x · Cited by 53 · see citing works
Serum HE4 and diagnosis of ovarian cancer in postmenopausal women with adnexal masses
Gentry‐Maharaj, A., Burnell, M., Dilley, J., Ryan, A., Karpinskyj, C., Gunu, R., Mallett, S., Deeks, J. J., Campbell, S. C., Jacobs, I. J., et al. (2019) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2019.07.031 · Cited by 44 · see citing works
Moro, F., Magoga, G., Pasciuto, T., Mascilini, F., Moruzzi, M. C., Fischerová, D., Savelli, L., Giunchi, S., Mancari, R., Franchi, D., et al. (2018) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.19026 · Cited by 42 · see citing works
Yasunaga, M., Ohishi, Y., Oda, Y., et al. (2009) · Human Pathology · doi:10.1016/j.humpath.2008.12.006 · Cited by 40 · see citing works
Senthong, A.-J., Kitkumthorn, N., Rattanatanyong, P., Khemapech, N., Triratanachart, S., & Mutirangura, A. (2013) · International Journal of Gynecological Cancer · doi:10.1097/igc.0000000000000021 · Cited by 39 · see citing works
Yoshida, A., Derchain, S., Pitta, D. R., et al. (2016) · Gynecologic Oncology · doi:10.1016/j.ygyno.2016.01.023 · Cited by 38 · see citing works
Bandiera, E., Zanotti, L., Fabricio, A. S. C., et al. (2013) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2013-0151 · Cited by 37 · see citing works
Endometriosis-Associated Ovarian Cancer
Barreta, A., Sarian, L. O., Ferracini, A. C., Eloy, L., Brito, A. B. C., Andrade, L. A. L. D. A., & Derchain, S. (2018) · International Journal of Gynecological Cancer · doi:10.1097/igc.0000000000001317 · Cited by 36 · see citing works
Malkasian, G. D., Knapp, R., Lavin, P., et al. (1989) · International Journal of Gynecology & Obstetrics · doi:10.1016/0020-7292(89)90627-9 · Cited by 33 · see citing works
Predictive factors for the presence of malignant transformation of pelvic endometriosis
Kadan, Y., Fiascone, S. J., McCourt, C. K., Raker, C., Granai, C. O., Steinhoff, M. M., & Moore, R. G. (2014) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2014.11.029 · Cited by 32 · see citing works
Taniguchi, F., Harada, T., Kobayashi, H., Hayashi, K., Momoeda, M., & Terakawa, N. (2014) · Gynecologic and Obstetric Investigation · doi:10.1159/000357819 · Cited by 31 · see citing works
Nikolova, T., Živadinović, R., Evtimovska, N., Klisarovska, V., Stanojević, M., Georgievska, J., & Nikolova, N. (2017) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.13466 · Cited by 16 · see citing works
Sonographic Pattern Recognition of Endometriomas Mimicking Ovarian Cancer
Saeng-Anan, U., Pantasri, T., Neeyalavira, V., et al. (2013) · Asian Pacific Journal of Cancer Prevention · doi:10.7314/apjcp.2013.14.9.5409 · Cited by 6 · see citing works
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Research works printed but not linked: 1
- [21]Shimada M, Terakawa N Management of chocolate cyst from the view point of malignant transformation of endometriosis. J Jpn Obstet Gynecol Soc 2007; 59: 1045– 50.
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Bahall, V., De Barry, L., & Rampersad, A. (2022) · World Journal of Surgical Oncology · doi:10.1186/s12957-022-02553-x · Cited by 22 · see citing works
“Thus, a considerable increase in CA-125 concentrations may increase the suspicion of malignancy [20].”
BackgroundRectus Abdominis Muscle Endometriosis: A Unique Case Report with a Literature Review
Turčić, M., Matušan Ilijaš, K., Rajković Molek, K., & Valković Zujić, P. (2025) · Current Issues in Molecular Biology · doi:10.3390/cimb47010047 · Cited by 6 · see citing works
Deng, P., Weng, C., Xu, J., & Nie, H. (2024) · Journal of Obstetrics and Gynaecology Research · doi:10.1111/jog.16000 · Cited by 3 · see citing works
- Authors
- Shinmura, H., Yoneyama, K., Harigane, E., Tsunoda, Y., Fukami, T., Matsushima, T., & Takeshita, T.
- Affiliations
- Nippon Medical School Musashi Kosugi Hospital (JP)
- Nippon Medical School (JP)
- Corresponding author
- Shinmura, Hiroki
- Venue
- International Journal of Gynecological Cancer
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 30
- Issue
- 6
- Pages
- 831-836
- ISSN
- 1048-891X (ISSN-L)
- PMC
- PMC7362875
- OpenAlex
- W3021420087
- Cited by
- 24
- References
- 30
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 2
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Gynecological Cancer (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- endometrioma, tumor markers, CA19-9, carcinoembryonic antigen, sialyl Lewis X, lactate dehydrogenase, CA125, preoperative diagnosis, differential diagnosis, mural nodules, tumor size, age, ovarian cancer risk stratification, endometriosis
- MeSH terms
- Adult, Aged, Aged, 80 and over, Diagnosis, Differential, Endometriosis, Female, Humans, Middle Aged, Ovarian Neoplasms, Biomarkers, Tumor, Case-Control Studies, Young Adult
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