Parameters of blood count and tumor markers: a retrospective analysis and relation to prognostic factors in ovarian cancer

Purpose of Investigation: The aims of study were to evaluate potential prognostic laboratory factors in ovarian cancer (blood count parameters and tumor markers) and to relate these parameters with prognostic factors. Materials and Methods: The authors evaluated patients that underwent surgical treatment and with confirmed histopathologic diagnosis of ovarian cancer. Age, FIGO stage, type of surgery, serum levels of tumor markers, parameters of blood count, disease-free and overall survival were recorded. Mann-Whitney test was performed. The significance level was less than 0.05. Results: Higher levels of CA 125, CA 15.3, and platelets were found in the group with Stage III/IV, since hemoglobin levels were higher in stage I/II (p < 0.05). CEA levels were higher in the group of non-serous neoplasms (p < 0.05). Higher levels of CA125, CA15.3 and platelets were seen in the group histological grade 2/3 (p < 0.05). Conclusion: CA 125, CA 15.3, hemoglobin, and platelets can be related prognostic factors in ovarian cancer.

Ovarian neoplasms; Blood cell count; Blood platelets; Prognosis; CA-125 antigen; CA-19-9 antigen.

[1] Landen C.N. Jr., Birrer M.J., Sood A.K.: “Early events in the pathogenesis of epithelial ovarian cancer”. J. Clin. Oncol. 2008, 26, 995.

[2] Roett M.A., Evans P.: “Ovarian cancer: an overview”. Am. Fam. Physician 2009, 80, 609.

[3] Mironov S., Akin O., Pandit-Taskar N., Hann L.E.: “Ovarian Cancer”. Radiol. Clin. N. Am. 2007, 45, 149.

[4] Gadducci A., Cosio S., Zola P., Landoni F., Maggino T., Sartori E.: “Surveillance procedures for patients treated for epithelial ovarian cancer: a review of the literature”. Int. J. Gynecol. Cancer, 2007, 17, 21.

[5] Morikawa Y., Kawai M., Kano T., Kikkawa F., Oguchi H., Nakashima N., et al.: “Clinical remission criteria for epithelial carcinoma of the ovary”. Gynecol. Oncol., 1993, 48, 342–8.

[6] Mok S.C., Kwong J., Welch W.R., Samimi G., Ozbun L., Bonome T., et al.: “Etiology and pathogenesis of epithelial ovarian cancer”. Dis. Markers, 2007, 23, 367.

[7] Crasta J.A., Premlatha T.S., Krishnan S.M., Vallikad E., Rameshkumar K.: “Significance of preoperative thrombocytosis in epithelial ovarian cancer”. Indian J. Pathol. Microbiol., 2010, 53, 54.

[8] Eichbaum M.H., Weiss L.M., Bruckner T., Schneeweiss A., Sinn H.P., Gebauer G., et al.: “Prognostic impact of hemoglobin levels before and during carboplatin/taxane-based chemotherapy in patients with primary invasive epithelial ovarian cancer”. Med. Sci. Monit., 2009, 15, CR156.

[9] Pongsanon K., Benjapibal M., Ruengkhachorn I.: “Prognostic significance of hemoglobin levels in patients with primary epithelial ovarian carcinoma undergoing platinum-based chemotherapy”. Asian Pac. J. Cancer Prev., 2011, 12, 131.

[10] Gadducci A., Cosio S., Tana R., Genazzani A.R.: “Serum and tissue biomarkers as predictive and prognostic variables in epithelial ovarian cancer”. Crit. Rev. Oncol. Hematol., 2009, 69, 12.

[11] Gadducci A., Cosio S., Zola P., Sostegni B., Fuso L., Sartori E.: “Prognostic factors and clinical outcome of patients with recurrent early-stage epithelial ovarian cancer: an Italian multicenter retrospective study”. Int. J. Gynecol. Cancer, 2013, 23, 461.

[12] Kolwijck E., Thomas C.M., Bulten J., Massuger L.F.: “Preoperative CA-125 levels in 123 patients with borderline ovarian tumors: a retrospective analysis and review of the literature”. Int. J. Gynecol. Cancer, 2009, 19, 1335-8.

[13] Wu T.I., Lee C.L., Wu M.Y., Hsueh S., Huang K.G., Yeh C.J., Lai C.: “Prognostic factors predicting recurrence in borderline ovarian tumors”. Gynecol. Oncol., 2009, 114, 237.

[14] Murta E.F., Silva C.S., Gomes R.A., Tavares-Murta B.M., Melo A.L.: “Ultrasonography criteria and tumor marker assay are good procedures for the diagnosis of ovarian neoplasia in preselected outpatients”. Eur. J. Gynaec. Oncol., 2004, 25, 707.

[15] Murta E.F., Nomelini R.S.: “Early diagnosis and predictors of malignancy of adnexal mass”. Curr. Opin. Obstet. Gynecol., 2006, 18, 14.

[16] Heeran M.C., Høgdall C.K., Kjaer S.K., Christensen L., Jensen A., Blaakaer J., et al.: “CA125 expression pattern, prognosis and correlation with serum CA125 in ovarian tumor patients. From The Danish ‘MALOVA’ Ovarian Cancer Study”. Gynecol. Oncol., 2007, 104, 508.

[17] Cooper B.C., Sood A.K., Davis C.S., Ritchie J.M., Sorosky J.I., Anderson B., Buller R.E.: “Preoperative CA 125 levels: an independent prognostic factor for epithelial ovarian cancer”. Obstet. Gynecol., 2002, 100, 59.

[18] Makar A.P., Kristensen G.B., Kaern J., Børmer O.P., Abeler V.M.,m Tropé C.G.: “Prognostic value of pre- and postoperative serum CA 125 levels in ovarian cancer: new aspects and multivariate analysis”. Obstet. Gynecol., 1992, 79, 1002.

[19] Zanaboni F., Vergadoro F., Presti M., Gallotti P., Lombardi F., Bolis G.: “Tumor antigen CA 125 as a marker of ovarian epithelial carcinoma”. Gynecol. Oncol., 1987, 28, 61.

[20] Geisler J.P., Miller G.A., Lee T.H., Harwood R.M., Wiemann M.C., Geisler H.E.: “Relationship of preoperative serum CA-125 to survival in epithelial ovarian carcinoma”. J. Reprod. Med., 1996, 41, 140.

[21] Paramasivam S., Tripcony L., Crandon A.: “Prognostic importance of preoperative CA-125 in International Federation of Gynecology and Obstetrics stage I epithelial ovarian cancer: an Australian multicenter study”. J. Clin. Oncol., 2005, 23, 5938.

[22] Høgdall E.V., Christensen L., Kjaer S.K., Blaakaer J., Jarle Christensen I., Gayther S., et al.: “Protein expression levels of carcinoembryonic antigen (CEA) in Danish ovarian cancer patients: from the Danish ‘MALOVA’ovarian cancer study.” Pathology, 2008, 40, 487.

[23] Kudoh K., Kikuchi Y., Kita T., Tode T, Takano M, Hirata J., et al.: “Preoperative determination of several serum tumor markers in patients with primary epithelial ovarian carcinoma”. Gynecol. Obstet. Invest., 1999, 47, 52.

[24] Raungkaewmanee S., Tangjitgamol S., Manusirivithaya S., Srijaipracharoen S., Thavaramara T.: “Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer”. J. Gynecol. Oncol., 2012, 23, 265.

[25] Zeimet A.G., Marth, Müller-Holzner E., Daxenbichler G., Dapunt O.: “Significance of thrombocytosis in patients with epithelial ovarian cancer”. Am J. Obstet. Gynecol., 1994, 170, 549.

[26] Münstedt K., Kovacic M., Zygmunt M., Von Georgi R.: “Impact of hemoglobin levels before and during chemotherapy on survival of patients with ovarian cancer”. Int. J. Oncol., 2003, 23, 837.

[27] Bryne M., Eide G.E., Lilleng R., Langmark F., Thrane P.S., Dabelsteen E.: “A multivariate study of the prognosis of oral squamousm cell carcinomas. Are blood group and hemoglobin new prognostic factors?” Cancer, 1991, 68, 1994-8.

[28] Chen Y., Zhang L., Liu W.X., Liu X.Y.: “Prognostic significance of preoperative anemia, leukocytosis and thrombocytosis in chinese women with epithelial ovarian cancer”. Asian Pac. J. Cancer Prev., 2015, 16, 933.

[29] Allensworth S.K., Langstraat C.L., Martin J.R., Lemens M.A., Mc- Gree M.E., Weaver A.L., Dowdy S.C., et al.: “Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer”. Gynecol. Oncol., 2013, 130, 499.

[30] Macciò A., Madeddu C., Massa D., Mudu M.C., Lusso M.R., Gramignano G., et al.: “Hemoglobin levels correlate with interleukin-6 levels in patients with advanced untreated epithelial ovarian cancer: role of inflammation in cancer-related anemia”. Blood, 2005, 106, 362.

[31] Nomelini R.S., Silva T.M., Tavares-Murta B.M., Murta E.F.: “Parameters of blood count and tumor markers in patients with borderline ovarian tumors: a retrospective analysis and relation to staging”. ISRN Oncol., 2012, 2012, 947831.