Background: Therapy monitoring by noninvasive means and early detection of recurrence are still not satisfactorily solved in ovarian carcinoma. One of the main reasons is the extraordinary morphologic heterogeneity of ovarian carcinomas. The situation has improved considerably in serous ovarian carcinomas since the detection of the tumor marker CA 125. But, in our opinion, the determination of additional tumor markers could further improve the detection of nonserous ovarian carcinomas. Material and Methods: To verify this hypothesis we measured simultaneously three considerably different markers for ovarian carcinomas, CA 125 (MW about 500 kD, ELISA), SRA (total serum ribonuclease activity), (MW between 10 and 45 kD, enzymatic test), and CA 72-4 (MW about 220 kD, RIA), and compared the clinical validity of various marker combinations. Results: We investigated serum samples of a total of 215 patients, 85 with histologically confirmed ovarian carcinoma, 70 with histologically confirmed benign ovarian tumors, and 60 controls. By simultaneously determining these three tumor markers, in 98% of the ovarian carcinomas of our collective at least one marker was found to be elevated before therapy. Noticeably, this finding was independent of the histology of the carcinomas. Conclusions: Our results suggest that the simultaneous and pretherapeutic determination of the three tumor markers CA 125, SRA, and CA 72-4 represents a suitable means to detect at least one marker for the noninvasive monitoring of therapy and aftercare.

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