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    Subjects/Pathology/Tumor Markers
    Tumor Markers
    easy
    microscope Pathology

    Which tumor marker is the most commonly elevated in ovarian epithelial cancers and is used for monitoring treatment response and detecting recurrence?

    A. Human chorionic gonadotropin (hCG)
    B. Carcinoembryonic antigen (CEA)
    C. Cancer antigen 125 (CA-125)
    D. Alpha-fetoprotein (AFP)

    Explanation

    ## CA-125 in Ovarian Cancer **Key Point:** CA-125 is the most commonly used tumor marker for epithelial ovarian cancer (EOC), elevated in >80% of advanced-stage cases and used for monitoring and recurrence detection. ### CA-125 in Ovarian Cancer: | Feature | Details | |---------|----------| | Elevation frequency | >80% in advanced EOC | | Normal cutoff | <35 U/mL | | Sensitivity (advanced) | 80–90% | | Specificity | 95% in high-risk populations | | Clinical use | Diagnosis, prognosis, monitoring | | Recurrence detection | Doubling time <6 months = poor prognosis | ### Why CA-125 is Most Common: - Produced by ovarian cancer cells and normal peritoneal cells - Elevated in >80% of stage III–IV EOC - Serial measurement guides chemotherapy efficacy - Rapid rise after normalization indicates recurrence - Integrated into FIGO staging and prognostic scoring **Clinical Pearl:** A rise in CA-125 during remission often precedes clinical recurrence by 3–6 months, making it valuable for surveillance. **High-Yield:** CA-125 is NOT specific to ovarian cancer (elevated in endometriosis, menstruation, other malignancies) but is the most common and most useful marker for EOC monitoring.

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