TITLE:
Early Diagnosis of Gynecological Cancers in Ladies with Review of Literature
AUTHORS:
Tanushri Mukherjee, Soma Mukherjee, Rajat Dutta
KEYWORDS:
Gynaecological Cancers, Tumor Markers
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.5,
May
23,
2017
ABSTRACT: The most prevalent cancers in ladies are cervical, endometrial and Ovarian. The biomarkers prevalent in use for these gynaecological cancers are commonly Cancer antigen 125 (CA-125), B, Alpha-fetoprotein (AFP), Inhibin, Carcinoembryonic antigen (CEA), Squamous cell carcinoma (SCC) antigen, Carbohydrate antigen 19-9, Cancer antigen 27-29, Human epididymis protein 4 (HE4), Osteopontin, transthyretin, Immunosuppressive acidic protein(IAP), leptin, CA15-3, CK19 and Thymidine kinase. The biomarker marker Squamous cell carcinoma (SCC) antigen, CK19 and immunosuppressive acidic protein IAP are raised in cervical squamous cell carcinomas. Endometrial cancer is a common cancer in women. In 75% of endometrial cancer cases, the tumor remains confined to the uterus and has a favorable prognosis if early detected. The prognosis, however, worsens dramatically as the disease progresses. The objective of this review is to elucidate the importance of the tumor markers for early diagnosis of gynaecological malignancies which are vital and life saving. Similarly the relevant biomarkers in combination are found to have positive predictive values and significant p values in the endometrial and cervical cancer. In Cervix cancer the positive predictive value of these markers combined is usually 92% - 95% and negative predictive value 93% - 96%. The confidence interval is 98% and p value significant 0.005. Sensitivity of tumor markers combined CK19, SCC and immunosuppressive acidic protein IAP in Cervix cancer detection is 95% and specificity 96%. The highest sensitivity was for SCC antigen (98.7%) while the highest specificity was for Cytokeratin 19 (99.7%). The positive predictive value by combination of CK19, SCC and IAP for the detection of Cervix cancer was 90% - 94%. In endometrial cancer the sensitivity of tumor markers combined CA19-9, CA125, leptin, thymidine kinase, CEA, CA15-3, and HE4 in endometrial cancer detection was 95% and specificity 96%. The highest sensitivity was for CA125 (99.7%) while the highest specificity was for CA19-9 (95.7%) which revealed that the efficacy of CA19-9 was more than that of CA125. The positive predictive value by combination of CA19-9, CA-125 levels, HE4, CA15-3, leptin, thymidine kinase and CEA for the detection of Endometrial cancer was 93%. For Gynecological malignancies namely Ovarian, Cervix and Endometrial cancers screening with these novel tumor markers in combination which are significant to a particular group of cancers.