Tumour markers in gynaecologic oncology.

Human chorionic gonadotropin is a highly sensitive and specific tumour marker for gestational trophoblastic disease and reflects accurately tumour volume and clinical course of the disease. Alpha-fetoprotein is usually a reliable marker for endodermal sinus tumours and embryonal carcinomas, and also predicts the presence of yolk sac elements in mixed germ cell tumours. Squamous cell carcinoma antigen can be useful in the detection of recurrent cervical carcinoma. Carcinoembryonic antigen determination can be of help to distinguish adenocarcinomas of the cervix from those of the endometrium. Thus far, CA125 is the most widely used tumour marker in gynaecologic oncology. Its main area of application is epithelial ovarian carcinomas where it is useful for disease monitoring during and after therapy. The specificity of the CA125 test is too low for use in preoperative diagnosis. The utility of CA125 for screening depends on combinations with other diagnostic methods, such as pelvic examination and ultrasound. No combination of tumour markers has so far proven superior to CA125 alone.