Preoperative Serum CA125 and Plasma Fibrinogen Levels as Predictors of Lymphovascular Space Invasion in Endometrial Cancer
Keywords:Lymphovascular space invasion, CA125, plasma fibrinogen, endometrial cancer
Background: Lymphovascular space invasion has been shown to be a predictor of lymph node metastasis
and decreased survival in patients with endometrial cancer. Unfortunately, LVSI status is most commonly
not available until after hysterectomy at the time of preparation of the final Pathology report. Therefore;
LVSI status represent additional information to be considered in decision making process regarding whether
to perform lymphadenectomy or to deliver adjuvant therapy. Thus, it was important to find biomarkers to
predict the risk of LVSI before surgery.
Objective: To evaluate the value of serum CA125 and plasma fibrinogen for prediction of lymphovascular
space invasion in women with endometrial cancer.
Study Design: A prospective observational cross-sectional study.
Settings: was carried out in the Department of Obstetrics and Gynecology/ Baghdad Teaching Hospital, and
Nursing Home Hospital in Medical City complex, Baghdad, Iraq, over a period of 1 year starting from the
first of December 2017 to the end of November 2018.
Patients and Methods: Fifty-five women with endometrial cancer undergoing surgery were included in
this study. We compared the preoperative level of serum CA125 and plasma fibrinogen with postoperative
histopathological report regarding LVSI, the results were statistically analyzed.
Results: (16.4%) of the patients with positive lympho-vascular invasion. CA-125, Fibrinogen, were highly
significantly increased in patients with positive LVSI. Sensitivity was (88.9%), specificity (95.7%), negative
predictive value (95.0%), positive predictive value (91.0%),and accuracy of the test was (92.3%)when
the cutoff value for CA125 was (28.75U/ml) while for plasma fibrinogen in cutoff value (317mg/dl)the
sensitivity was (100.0%), specificity (95.7%),negative predictive value (100.0%), positive predictive value
(95.9%) and the accuracy of the test was (97.8%)
Conclusion: The preoperative assessment of serum CA 125 and plasma fibrinogen could be used to predict
the LVSI in endometrial cancer.
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