Prognostic significance of CA-125 re-elevation after interval debulking surgery in patients with advanced-stage ovarian cancer undergoing neoadjuvant chemotherapy

Lee, Yong Jae,Chung, Young Shin,Lee, Jung-Yun,Nam, Eun Ji,Kim, Sang Wun,Kim, Sunghoon,Kim, Young Tae Elsevier 2019 European journal of surgical oncology Vol.45 No.4

<P><B>Abstract</B></P> <P><B>Aims</B></P> <P>We evaluated the prognostic significance of postoperative re-elevation of cancer antigen-125 (CA-125) levels in patients with ovarian cancer and preoperative normalization of CA-125 levels after neoadjuvant chemotherapy (NAC).</P> <P><B>Methods</B></P> <P>The data of 103 patients with preoperative CA-125 normalization after NAC at the Yonsei Cancer Hospital (2006–2017) were analyzed. We compared the clinical characteristics and survival outcomes among patients with normal postoperative CA-125 levels and those with re-elevated CA-125 levels after interval debulking surgery (IDS). CA-125 elevation was defined as levels >35 U/mL.</P> <P><B>Results</B></P> <P>Among 103 patients, 52 (50.5%) and 51 (49.5%) had normal and re-elevated CA-125 levels after IDS, respectively. Patients with CA-125 re-elevation underwent more radical surgeries during IDS than those with normal CA-125 levels (p = 0.018). We found no significant differences in progression-free survival (PFS; p = 0.726) or overall survival (OS; p = 0.293) between the two groups. Moreover, patients with persistent CA-125 elevation (3 weeks after IDS) did not have inferior PFS (p = 0.171 and p = 0.208, respectively) or OS (p = 0.128 and p = 0.095, respectively) compared to patients with early normalization (within 3 weeks of IDS) or normal CA-125 levels. Multivariate regression showed that CA-125 re-elevation had no effect on recurrence (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.43–1.30) or death (HR, 0.99; 95% CI, 0.33–2.98).</P> <P><B>Conclusion</B></P> <P>Among patients with preoperative CA-125 normalization after NAC, postoperative CA-125 re-elevation had no prognostic value. Novel and reliable biomarkers reflecting the tumor response after IDS should be identified.</P>

결핵성 복막염에서 CA 125의 진단적 의의

안현택,서강석,김현수,최성규,유종선,김세종 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3

위장관계 악성종양에서 CA 125 측정의 의미

장우익 ( Jang U Ig ),안강현 ( An Gang Hyeon ),이종인 ( Lee Jong In ),김현수 ( Kim Hyeon Su ),김효열 ( Kim Hyo Yeol ),김수경 ( Kim Su Gyeong ),이동기 ( Lee Dong Gi ),배선우 ( Bae Seon U ),심영학 ( Sim Yeong Hag ),강명서 ( Kang Myeo 대한내과학회 1993 대한내과학회지 Vol.44 No.4

연구배경 : 종양표지자는 암외 진단, 임상적 병기구분 및 치료효과 판정에 유용하며, 위장관암에서 alphafetoprotein, carcinoembryonic antigen, CA 19-9, 및 CA 72-4 등이 중요한 지표로 사용되고 있으나 위암의 경우, 현재까지 만족할 만한 유용성을 가진 종양표지자는 없는 실정이다. 저자등은 위암에 대한 새로운 종양표지자로 CA 125의 역할을 규명하고자 위암을 비롯한 각종 위장관암에서 CA 125와 기존의 종양표지자와의 유용성을 검토하였다. 방법 : 대상은 위장관 악성종양 181예, 위장관 양성질환자 55예를 대상으로 하였으며 CA 72-4는 CIS ELSA CA 72-4 RIA kit, CA 19-9는 Abbott CA 19-9 RIA kit, CEA는 Abbott CEA kit, CA 125는 Centocor CA 125 RIA kit를 사용하여 측정하였으며, 각각의 정상치 한계는 4 U/ml, 37 U/ml, 5ng/ml그리고 35 U/ml로 하였다. 결과 : 1) CA 125는 양성 소화기 질환에서 93%의 높은 특이도를 보였으나 복수가 있는 간경변증의 경우 거의 전예에서 혈중 CA 125값이 증가하여 악성종양군과 감별이 어려웠다. 2) CA 125는 위암에서 민감도가 36%로 CA 72-4와 차이가 없었다. 3) CA 125는 췌담도암에 대한 민감도가 55%로 CA 19-9의 85%에 비해 낮았으며 두 종양표지자를 병합하여 사용한 경우 민감도의 증가(95%)를 볼 수 있었다. 4) 23예의 조기위암 환자에서 CA 125의 민감도는 9%로 낮았다. 5) Conventional image study 상으로 인지되지 않은 복강내 암종증 환자에 대한 CA 125의 민감도는 36%였다. 결론 : CA 125는 위암에서 기존의 종양표지자인 CA 72-4와 유용성의 차이를 보이지 않았으며 전이성 위암에서 높은 민감도를 나타내었다. 혈중 CA 125의 증가는 위장관의 악성 및 양성질환에 관계없이 복수의 유무와 밀접한 연관관계를 가지는 것으로 사료되며 통상적인 영상 진단법상으로 인지되지 않은 복강내 암종중의 예견에 있어서는 유용하지 않을 것으로 생각된다. Background: Detection of tumor markers could offer an accessible method for screening risk groups in order to achieve an early diagnosis of cansers, to contribute to and adequate staging, and to help evaluate effects of therapy. CA 125 is an antigenic determinant defined by murine monoclonal antibody OC 125, and synthesized by coelomic epithelial derivatives such as Mullerian epithelium and mesothelial tissues. CA 125 is regarded as useful tumor marker for non-musinous epithelial ovarian tumors. So we investigated whether CA 125 is reliable tumor marker for gastrointestinal malignancies and especially for detection of intraperitoneal carcinomatosis unrecognized by conventional imaging studies. And we compared CA 125 with other conventional tumor markers in the serodiagnosis of gastrointestinal malignancies. Methods: Serum CA 72-4, CA 19-9, CA 125 and CEA were determined radioimmunologically with monoclonal antibodies. A cut-off value of 4 U/ml, 37 U/ml, 35 U/ml and 5 mg/ml were used respectively. Results: The results are summarized as follows. 1) CA 125 had high specificity (93%) for benign gastrointestinal disease but was not useful to differetiate malignant ascites and benign ascites. 2) In gastric carcinoma, the sensitivity of CA 125 (36%) was not so different to that of CA 72-4(36%). 3) In pancreatobiliary carcinoma, the sensitivity of CA 125(55%) was inferior than that of CA 19-9 (85%), but combined use of these two tumor markers increases sensitivitu(95%) for the diagnosis. 4) The sensitivities of CA 125 for 23 early gastric cancer was 9%. 5) The sensitivities of CA 125 for the intraperitoneal carcinomatosis that was not recognized by conventional imaging studies was 36%. Conclustion: Our data indicates that CA 125 is not better in the serodiagnosis of gastrointestinal malignancies than other conventional tumor markers, and CA 125 has a little predictive value in the diagnosis of intraperitoneal carcinomatosis unrecognized by the conventional imaging studies. Serum CA 125 elevation in benign or malignant diseases closely correlated with the presence of ascites.

질출혈을 동반한 자궁내 초기임신에서 혈중 CA125의 임신예후 예측 효용성

정지윤 ( Ji Youn Chung ),문종수 ( Chong Soo Moon ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.6

목적: 질출혈이 동반된 초기임신에서 임신의 예후를 알아보기 위하여 혈중 CA125를 측정하여 그 농도가 급격하게 증가하거나 고농도를 유지하는 경우에 유산의 발생을 예측할 수 있는 지를 알아보고, 만약 그 가치가 존재한다면 기준값을 알아보기 위하여 본 연구를 시행하였다. 연구 방법: 임신 초기에 질출혈이 동반된 임신부 40명을 대상으로 하였다. 첫 방문 시에 혈중 CA125를 측정하였으며 이후 1주 간격으로 임신 1삼분기까지 추적검사하였으며, 이 때 유산으로 확인된 경우에는 소파수술 후 추적을 중단하였다. 모든 방문 시에는 β-hCG와 초음파 검사를 동시에 시행하였다. 결과: 결국 14명에서 유산이 발생하였고 26명은 임신이 지속되었다. 유산은 대부분 혈중 CA125 농도가 유의하게 증가한 경우에 발생하였으며, ROC 곡선에서 150 U/mL가 유산예측의 기준 농도로 가장 의미가 있었다. CA125 농도가 150 U/mL 이상이었던 17명 중에서 12명이 유산되었고, 150 U/mL 미만이었던 23명 중에서는 2명이 유산되어 유산발생에 대한 양성예측도와 음성예측도는 각각 70.6%와 91.3%였다(P<0.01). 결론: 임신 초기의 모체 혈중 CA125 농도는 임신의 예후를 판정하는 제 3의 중요한 예측인자가 될 수 있다. 특히 임신 초기에 질출혈이 동반된 경우에 CA125의 농도가 갑자기 증가한다면 유산의 발생을 강력히 예견할 수 있으며, 기존의 혈중 β-hCG와 초음파와 같이 적용한다면 임신 예후 예측에 더욱 가치가 있을 것으로 사료된다. Objective: To investigate whether sudden rise or already increased level of maternal serum CA125 predicts spontaneous abortion in early pregnancy with vaginal bleeding. And if so, to decide the CA125 cut-off level for poor pregnancy outcomes. Methods: The prospective study was performed in forty women presenting with any vaginal bleeding at early pregnancy. Maternal serum CA125 levels were evaluated on the first visit and followed up during the first trimester, or until the time to diagnose abortion. Serial maternal serum β-hCG and ultrasonographic evaluation were also performed at the same time. Results: There were eventually fourteen abortions and twenty-six ongoing pregnancies. Using receiver-operating characteristic curve, 150 U/mL of serum CA125 was the most useful value for predicting spontaneous abortion. In most of abortion women, the serum CA125 level was increased over than 150 U/mL immediately before the abortion. The twelve of 17 women who were 150 U/mL or more resulted in abortion, while there were just two cases of abortion among 23 women who were less than 150 U/mL. Its positive predictive value was 70.6% and negative predictive value was 91.3% respectively (P<0.01). Conclusion: There was a strong correlation between high level of serum CA125 and subsequent spontaneous abortion in early pregnancy. It should be valuable to check maternal serum CA125 added to β-hCG and ultrasound for predicting pregnancy outcome at the early pregnancy, especially in the cases with vaginal bleeding.

자궁경부암, 자궁근종 및 선근증 환자의 혈청과 병소내 CA 125 항원치

양동욱,이진희,서순팔 대한임상병리학회 1996 대한임상병리학회지 Vol.16 No.2

체외수정 시술 환자의 초기임신 결과 예측에 혈중 CA 125치의 효용성에 관한 연구

문종수,이상훈,김동호,배도환 중앙대학교 의과대학 의과학연구소 1994 中央醫大誌 Vol.19 No.1

The prediction of outcome at early pregnancy are very important to obstetrician and pregnant woman, especially in the pregnancies of infertility pateints. To the present, most of obstetric investigators have predicted the outcome of pregnancy at early first trimester via ultrasonography and serum β-hCG levels. But these mothods were spent much time and were showed relatively high incidence of false positive. The CA-125 that disocovered by using monoclonal antibodies derived from the ovarian cancer cell line OVCA 433, is present high in human amniotic fluid throughtout gestation. Extract of human decidua and chorion have been found to contain significant quantities of CA-125. In contrast, the serum CA-123 level is low in either maternal or fetal blood, and very little is found in extracts of amnion and trophoblast. The large CA-125 molecules from the cystic fluid or the amniotic fluid gain access to the serum compartment only as the epithelial basement membrane is disrupted via peritoneal lymphatics. The impending abortion may be associated with disruption of the epithelial basement membrane of either the fetal membrane or the decidua, leading to an increase in maternal serum CA-125 level. This increase may be a predictor of subsequent spontaneous abortion of the fetus. This study was initiated to investigate whether a sudden rise in the serum CA-125 level might predict spontaneous first-trimester abortions, and concomittant check with serum β-hCG and fetal growth on sonographic fingdings might predict subsequent abortion more early than other parameters without serum CA-125. And comparing with other parameters without serum CA-125, confirm to predictional value of subsequent spontaneous abortions. This study was undergone from October 1992 to May 1993 retrospectively for whom were treated by controlled ovarian hyperstimulation for IVF(In Vitro Fertilization) and ET (Embryo Transfer) program, visited to infertility clinic the department of Obstetics and Gynecology, the medical college, Chung-Ang university. The CA-125 levels of 30 cycles of IVF early pregnancy were evaluated on ET 12 days and follow up weekly to 11 weeks to determine wether there is a sudden increase immediately before or at the time of abortion. The results were as followed. The nine of 13 cycles with serum CA 125 level of 150 U/mL or greater were aborted and their positive predictive ration was 69.2% (p<0.01), compared with one of 17 cycles with serum CA-125 level less than 150 U/mL was aborted and its negative predictive value was 94.1% (p<0.01). And the nine of 10 cycles which had been aborted, had greater than 150 U/mL of serum CA-125. The level of CA-125, (six of 10 abortions) did not increase until much later, after fetal viability was established. As a conclusion indicated that there was a definite correlation between high level or sudden increased serum CA-125 levels and subsequent spontaneous abortion. On prediction of early pregnancy outcome, the check of serum β-hCG and fetal size engrowing on ultrasonography with serum CA-125 levels are more precise and decrease false positive.

임신 초기 정상임신과 유산에서 혈청 CA 125 농도와의 관계

신중식 ( Joong Sik Shin ),김태진 ( Tae Jin Kim ),김용민 ( Yong Min Kim ) 대한주산의학회 2003 Perinatology Vol.14 No.3

목적: 본 연구는 임신 제 1삼분기에 혈청 내 CA 125 수치가 갑자기 증가하는 경우 자연유산의 가능성이 높았다는 이전의 연구를 바탕으로 시작되었다. 이를 위하여 계류유산, 절박유산, 정상 임신부의 혈청 CA 125를 측정하였고 예후 인자로 가능한가를 분석하였다. 이 연구의 목적은 CA 125수치를 임신초기에 전향적으로 비교 분석하여 자연유산을 예측할 수 있는 검사법으로 가능한지를 판단하고 기초 자료로 이용하고자 시도 되었다. 연구 방법: 2001년 3월부터 2001년 9월까지 강남 차병원 산부인과 외래를 방문한 133명의 초기 임신부를 대상으로 하였으며 이 중 58명은 계류유산, 45명은 절박유산, 나머지 30명은 이전에 자궁내막증이나 난소의 종양이 없었던 정상 임신부였다. 이들의 임신 주수는 모두 6주에서 12주 사이였으며 모든 대상은 초음파로 확인하였고 각각의 대상에서 혈청내 CA 125를 검사 하였다. 결과: 각 연구군의 CA 125 평균은 계류유산이 72.9±102.0IU/ml였고, 절박유산은 46.6±37.9IU/ml였으며 정상임신부는 63.4±61.2IU/ml였다. 각 연구군 간에는 통계학적으로 큰 의미가 없었다. 결론: 본 연구 결과 혈청 CA 125 수치는 임신 초기에 자연 유산을 예측하는 예후인자로써 큰 의미가 없었으며 계류유산, 절박유산, 정상임신을 구별하는데도 큰 역할을 하지 못 하였다. Objective: The study was carried out to assess whether a sudden rise in the serum CA 125 level might predict spontaneous abortion in the first trimester. In the process, we assessed the clinical value of maternal CA 125 in patients with missed abortion and evaluate the prognostic significance of CA 125 in early normal pregnancies, threatened abortions. The purpose of this study was to prospectively compare serum CA 125 levels among women who abort in the first trimester, who experience threateneda bortion and who go through normal pregnancy. Methods: Between March 2001 and September 2001, a total of 133 patients were observed in the Department of Obstetrics and Gynecology at CHA Hospital. Fifty-eight with missed abortions, forty-five with threatened abortions and thirty normal pregnancies (no history of endometriosis or ovarian mass) were evaluated during gestational age 6 to 12 weeks and maternal serum samples were collected. All patients were sonographically assessed and CA 125 values were compared. Results: There was no statistically significant difference in the CA 125 levels between the spontaneous aborted patients and the patients without abortion: missed abortion, 72.9±102.0IU/ml (range 7.3-487.6); threatened abortion, 46.6±37.9IU/ml (range 13.9-206.1); normal pregnancy, 63.4±61.2IU/ml (range 13.8-62.8). Conclusion: Our study shows that serum CA 125 levels are not predictive of spontaneous abortion in the first trimester and failed to discriminate among missed abortions, threatened abortions, and normal pregnancies.

자궁내막증에서 혈청 CA125와 CA19-9의 임상적 의의

강태정(Tae Jung Kang),문혜성(Hye Sung Moon),정경아(Kyung Ah Jeong),정혜원(Hye Won Jung),안정자(Jung Ja Ahn) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.7

목적 : 자궁내막증은 진단시 다른 질환과의 감별이 어려우며 치료 후에도 재발 가능성이 높아 유용한 혈액지표의 개발이 요구되고 있다. 이에 저자 등은 자궁내막증 환자에서 치료 전 후와 재발시의 CA125 및 CA19-9 혈청값의 동태를 분석함으로써 자궁내막증의 진단 및 임상경과 추적검사와 재발에 대한 예측인자로서의 유용성을 알아 보고자 하였다. 방법 : 1994년 1월부터 1998년 12월까지 월경통이나 불임, 골반통 등을 주소로 이화여자대학교 목동병원 산부인과 외래를 내원한 환자 중, 복강경 및 개복술 시행 후 자궁내막증이 확인된 88명을 대상으로 하였다. 내원시와 치료개시후 3-6개월에 추적검사된 CA125와 CA 19-9을 후향성으로 조사, 분석(retrospective analysis)하였다. 결과 : 자궁내막증 환자군의 혈청 CA125와 CA19-9의 치료 전 평균치는 각각 81.0±252.5 및 36.6±53.4(mean±2SD,U/㎖)으로 대조군의 11.6±12.8 및 9.4±8.6 에 비하여 유의하게 높았고(p<0.05), 전체 민감도는 CA125가 53.4%, CA19-9이 42.9%, 병합시 64.3%였으며 제 3,4기의 경우 각각 85.4% 및 55.0%로 제 1,2기에 비하여 유의하게 증가하였다(p<0.05). 혈청 CA125는 병기에 비례하여 유의한 상승을 보였고(p<0.05) CA19-9는 증가하는 경향을 보였으며(p=0.055), 양자 모두 치료 후 유의하게 감소하였다(p<0.05). 또한 치료 종결 후 보다 재발시 혈청 CA125가 유의하게 증가하였다(p<0.05). 결론 : 혈청 CA125와 CA19-9는 자궁내막증 환자에서 진단시 질환의 중증도를 판정하고 치료 경과 및 재발예측을 위한 추적검사로서 유용하다. Objective : Because endometriosis is difficult to diagnose and has a high recurrence rate after treatment, a reliable serum marker of endometriosis is necessary. Therefore, the aim of this study is to measure the serum levels of CA125 and CA19-9 in patients with endometriosis before and after treatment and during recurrence, and to assess the usefulness of these levels in the diagnosis, clinical follow up and prediction of recurrence in endometriosis.Methods : Eighty-eight patients who visited the department of Obstetrics and Gynecology of Ewha Mokdong Hospital from January 1994 to December 1998 and were diagnosed as endometriosis by laparoscopy or explo-laparotomy were enrolled as subjects. A retrospective analysis of serum CA125 and CA19-9 levels at 1 month before and 3 to 6 months after initiation of treatment was done.Results : The serum CA125 and CA19-9 levels of endometriosis group(81.0±252.5, 36.6±53.4 ; mean±2SD, U/ml) before treatment was significantly higher than control group(11.6±12.8, 9.4±8.6)(p<0.05). Overall sensitivity rate for CA125, CA19-9 levels and both was 53.4%, 42.9% and 64.3% respectively. The sensitivity rate for endometriosis, stage 3 and 4(85.4%, 55.0%) was significantly higher than that, stage 1 and 2(p<0.05). The serum CA125 level in endometriosis group showed a significant increment according to stages(p<0.05) while the serum CA19-9 level showed an increasing trend(p=0.055) and both levels decreased significantly after treatment(p<0.05). The serum CA125 level was also higher at recurrence after treatment(p<0.05). Conclusion : The serum CA125 and CA19-9 levels are a useful marker for diagnosing severity of disease, monitoring efficacy of treatment and predicting recurrence in endometriosis.

경계성 난소 종양 환자의 진단과 치료에 있어서 혈청 CA-125치의 임상적 의의

권혁,함형주,장선희,고재환,김용봉,이응수,박성관 인제대학교 1996 仁濟醫學 Vol.17 No.3

종양 표지물질인 CA-125는 악성 난소 종양의 진단 및 치료에 있어서 유용한 것으로 되어 있다. 그러나 경계성 난소 종양에 있어서는 아직 충분히 확립되지 못한 실정이다. 이에 저자들은 1989년 1월부터 1995년 12월까지 만 7년동안 인제대학교 의과대학 부속 서울백병원 산부인과에서 경계성 난소 종양으로 진단받았던 15명의 환자와 악성 난소 종양으로진단받았던 54명의 환자를 대상으로 각각에 대한 치료 전 및 치료 후 혈청 CA-125 치를 측정하여 비교 분석하여 경계성 난소 종양 환자의 진단과 치료에 있어서 혈청 CA-125치가 유용한지를 알아보고자 이 연구를 시행하였다. Serum tumor marker, CA-125 has been investigated extensively for it's usefulness in the diagnosis and management of malignant ovarian tumors. However, the role of serum CA-125in the diagnosis and management of patients with borderline ovarian tumors has not beenestablished. Retrospective analysis of serum CA-125 levels was performed in 15 patientsbefore operation and after treatment for borderline epithelial ovarian tumors at the Seoul Paik Hospital between 1989 and 1995. The result obtained were as follows : 1.The incidence of borderline malignant ovarian tumor among 69 cases of total group was 21.7%. 2.According to FIGO classification the patients were classified as: stage Ia (66.6%), stage Ib (6.7%), swage Ic (13.3%), stage IIc (6.7%), stage IIIa (6.7%). 3.The tumor sizes between patients with normal(less than 35 U/ml) and positive (over than 35 U/ml) of serum CA-125 were 15.43±5.06 cm and 15.78±4.91 cm, respectively and there was no statistical difference between the two groups (p> 0.05). 4.100% of serous and 46.2% of mucinous tumors had elevated CA-125 levels, and there was no statistical difference between the two groups(p> 0.05). 5.Combining both cell types, 6(46.2%) of 13 patients with swage I disease and 2(100%) of 2 patients with stage II and III disease had positive preoperative levels. Serum CA-125 level was no statistical difference between the two groups (p=0.467). 6.Serum CA-125 revels in patients with serous tumors (N=2) were decreased after surgery from 259.00 U/ml to 152.23 U/ml(p=0.04), and wish mucinous tumors (N=13) from 152.23 U/ml to 12.98U/ml (p=0.04) 7.CA-125 levels in patients with positive CA-125 level(N=8) were decreased after surgery from 294.57 U/ml to 18.01 U/ml (p=0.04), and with normal CA-125 level (N=7) from 7.61 U/ml to 5.25 U/ml (p=0.01). 8.Preoperative serum CA-125 levels in patients with malignant epithelial ovarian turners were 372.85 U/ml, and with borderline epithelial ovarian tumors were 166.47 U/ml. There was statistical difference between the two groups (p=0.006). These data suggest that preoperative serum CA-125 level correlates with stage of disease and serum CA-125 levels decrease after surgery regardless the initial level before treatment.

난소난관농양에서 혈청 CA 125의 임상적 의의

심인숙 ( In Suk Shim ),정혜원 ( Hye Won Chung ),안정자 ( Jung Ja Ahn ),문혜성 ( Hye Sung Moon ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.4

목적: 난소난관농양 환자의 혈청 CA 125를 포함한 ESR, CRP 수치 및 초음파 소견과 그 외 영향을 미치는 인자들을 조사, 분석하여 난소난관농양의 진단 및 수술적 중재 여부를 예측하고 추적검사를 할 수 있는 지표로서의 유용성을 알아보고자 하였다. 방법: 난소난관농양으로 입원한 총 65예의 난소난관농양 환자 중 보존적 치료에 성공한 29예를 보존적 치료군으로 설정하였고, 보존적 치료에 실패하여 침습적인 치료를 추가한 36예를 수술적 치료군으로 설정하였다. 연구 대상자들의 의무기록을 검토하여 후향적 연구를 시행하였다. 결과: 입원 시 측정한 혈청 CA 125를 비롯한 ESR, 농양의 크기는 난소난관농양의 치료에서 수술적 중재 여부 예측에 의미 있는 인자로 나타났다. 난소난관농양의 수술적 중재를 결정짓는 진단적 가치가 높은 인자는 ESR, 농양의 크기, CA 125순이며 이들의 새로운 양성 기준은 각각 36.5 mm/h, 4.2 cm, 68.3 U/ml이었다. CA 125 및 ESR의 민감도는 중증으로 진행된 병변에서 유의하게 증가하여 중증의 진행된 병변에서 진단적 가치가 있었다. 임상 경과의 추적 지표로서 CRP는 10일 내에 치료 경과 판정을 위한 추적검사로서 의의가 있으나 CA 125가 정상화되기까지 소요된 시간은 평균 51.5일로 CA 125는 단기간의 추적검사로서 부적절하다고 나타났다. 결론: 난소난관농양에서 CA 125, ESR 및 농양의 크기는 수술적 중재를 결정짓는 예측 인자이고 CA 125 및 ESR은 중증의 진행된 병변에서 진단적 가치가 있으나 CA 125는 임상 경과에 대한 단기간의 추적 지표로서 부적절함을 알 수 있다. 이를 바탕으로 난소난관농양의 진단 및 치료 기준안을 만들고 이에 따라 치료와 추적 검사를 시행한다면 치료 실패율을 현저히 낮추고 합병증과 재발을 줄이게 될 것이다. Objective: The aim of this study is to measure the serum levels of CA 125, ESR and CRP in patients with tubo-ovarian abscess (TOA) before and after treatment of abscess and to assess the usefulness of CA 125 in the diagnosis, prediction of the outcome of TOA treatment and clinical follow-up of patient`s condition. Methods: This retrospective study included 65 patients with TOA. Serum CA 125, ESR, CRP and WBC counts were measured. The treatment was done conservatively with antibiotics. The patients were divided into two groups: those with successful results into group 1 (29 cases) and those with unsuccessful results into group 2 (36 cases). If treatment was considered to be unsuccessful, surgical intervention was additionally performed. Results: The serum levels of CA 125, ESR and abscess size on admission in group 2 were significantly higher than in group 1. ESR, abscess size and CA 125 in order were valuable predictive factors affecting the success of medical treatment. And the new cutoff value was 36.5 mm/h, 4.2 cm and 68.3 U/ml, respectively. The sensitivity rate of CA 125, ESR levels was significantly higher in group 2 than in group 1. Although CRP was decreased significantly 10 days after treatment, the serum CA 125 was not decreased significantly. And it took 51.5 days for CA 125 to be normalized after the initiation of treatment. Conclusions: The serum CA125, ESR levels and abscess sizes are predictive factors affecting the success of medical treatment of abscess treatment. And CA 125 and ESR are useful for diagnosing severity of disease. But serum CA 125 level is an inappropriate marker for monitoring short-term efficacy of treatment.