ASSOCIATION OF CA125 LEVEL, HE4 AND ULTRASOUND MORPHOLOGY INDEX WITH EPITHELIAL OVARIAN CANCER IN PREMENOPAUSAL PERIOD
By : dr. I Made Adi Saputra Wijaya
Faculties : Fakultas Kedokteran
Department : PS. OBGYN
Ovarian cancer occurs in 4% of all cancers in women and is the fifth highest leading cause of death from all cancers in women. Overall incidence of symptomatic ovarian cysts become malignant in premenopausal women approximately 1 : 1000, increased to 3 : 1000 at the age of 50 years. Several examinations are commonly used to screen for ovarian cancer such as CA125 (cancer antigen 125), HE4 (human epididymis secretory protein 4) levels and transabdominal or transvaginal ultrasound. This study aims to determine the relationship between CA125 and HE4 levels, and ultrasound morphology with epitelial ovarian cancer in premenopausal period. A cross-sectional study was performed using consecutive sampling, involving 22 premenopausal patients with ovarian tumors who underwent surgery in Sanglah Hospital Denpasar from Januari 2015 to Desember 2015 and met the inclusion and exclusion criteria. History taking, physical, gynecologic and ultrasound examination previously performed. CA125 and HE4 levels were tested by taking 8cc of serum. Histopathological assay carried out after the tumor successfully removed through laparotomy were then categorized according to the criteria of benign and malignant epitelial ovarian tumor. Based on independent t-test on the variables of age, the mean age of patients with benign epitelial ovarian tumor was 36.67 ± 11.28 years and the mean age of patients with malignant epitelial ovarian tumor was 41.20 ± 11.18 years, p value p>0.05, which shows there was no difference between the two groups. There is no relationship between the use of contraception with the incidence of benign epitelial ovarian tumor and malignant epitelial ovarian tumor, p value p>0.05. The independent t-test on the variables of parity, the mean parity of patients with benign epitelial ovarian tumor was 1.92 ± 0.793 person and the mean parity of patients with malignant epitelial ovarian tumor was 1.50 ± 0.70 person, p value p>0.05, which shows there was no difference between the two groups. None of the patients who have a family history of ovarian cancer, breast cancer and colon cancer. To determine the association between CA125, HE4 levels and ultrasound morphology with ovarian cancer used Chi-Square test, with the respective results shows there was a significant association (PR = 3.6 , 95 % CI = 1.32 to 9.80 , p = 0.002), (PR = 2.5 , 95 % CI = 1.02 to 36.81 , p = 0.035), (PR = 7.62 , 95 % CI = 1.18 to 49.03 , p = 0.001). This study suggested there was significant association between the levels of CA125, HE-4 and ultrasound morphology index with epitelial ovarian cancer in premenopausal period. Further research is needed to strengthen the results of this study, with a sample of a larger and longer term.
Keyword : Ovarian cancer, CA125 level, HE4 and ultrasound morphology index