Pretreatment serum levels of CA-125, carcinoembryonic antigen, tissue polypeptide antigen, and placental alkaline phosphatase, in patients with ovarian carcinoma, borderline tumors, or benign adnexal masses: relevance for differential diagnosis

Gynecol Oncol. 1990 Oct;39(1):16-25. doi: 10.1016/0090-8258(90)90393-y.


Pretreatment serum levels of the antigens CA-125, tissue polypeptide Antigen (TPA), carcinoembryonic antigen (CEA), and placental alkaline phosphatase (PLAP) were determined in samples from 295 women with adnexal masses. At laparotomy 48% of patients had epithelial ovarian carcinoma, 9% had tumors of low malignant potential, and 8% suffered from malignancies of other kinds. The sensitivity of CA-125 with 35 U/ml as the cutoff was 88% in women with ovarian carcinoma, but 74% among those with limited disease and 58% in borderline malignancy. Only 6 of 17 mucinous ovarian carcinomas were detected. Specificity was 83%. CEA was elevated above 5.0 micrograms/liter in 15 of 17 patients with mucinous ovarian cancer. TPA detected advanced stages of malignancy, but the sensitivity was low, 53%, in cases with limited disease. PLAP was elevated in 46% of ovarian carcinoma patients. For detecting malignancy overall, the use of a parallel combination of the CA-125 and CEA assays was more sensitive than use of CA-125 as a single marker. This test combination may be of value in the diagnosis of adnexal masses. The predictive value of a positive result was 90%, and that of a negative result, 76%.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adnexal Diseases / diagnosis
  • Adnexal Diseases / immunology
  • Adolescent
  • Adult
  • Aged
  • Alkaline Phosphatase / analysis*
  • Antigens, Tumor-Associated, Carbohydrate / analysis*
  • Biomarkers, Tumor / analysis*
  • Carcinoembryonic Antigen / analysis*
  • Carcinoma / diagnosis
  • Carcinoma / immunology
  • Child
  • Diagnosis, Differential
  • Female
  • GPI-Linked Proteins
  • Humans
  • Isoenzymes / analysis*
  • Middle Aged
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / immunology
  • Peptides / analysis*
  • Placenta / enzymology*
  • Tissue Polypeptide Antigen


  • Antigens, Tumor-Associated, Carbohydrate
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • GPI-Linked Proteins
  • Isoenzymes
  • Peptides
  • Tissue Polypeptide Antigen
  • Alkaline Phosphatase
  • alkaline phosphatase, placental