CA 125 levels in the preoperative assessment of advanced-stage uterine cancer

Am J Obstet Gynecol. 2003 May;188(5):1195-7. doi: 10.1067/mob.2003.304.


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.

MeSH terms

  • CA-125 Antigen / blood*
  • Female
  • Humans
  • Lymph Nodes / pathology
  • Middle Aged
  • Myometrium / pathology
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Uterine Neoplasms / blood*
  • Uterine Neoplasms / pathology*


  • CA-125 Antigen