Tehran University Medical Journal

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Background: TPS is one of the tumor markers which has specially been considered due to its exclusive physiological characteristics like its easy measurement in serum of cancer patients. This study has been due to evaluate the efficiency of this tumor marker in the prognosis, treatment control and follow up of patients with gastrointestinal cancers including esophagus, stomach and colorectal.
Methods: TPS has been measured in 109 persons including 28 healthy people and 81 patients with different gastrointestinal malignancies which were composed of 38 patients with esophageal cancer, 20 ones with stomach cancer and 23 ones with colorectal cancer. Sampling has been done in three times depending on treatment methods. TPS has been measured with ELISA in samples which contend of 2 to 3 ml of serum from patients and the health.
Results: The obtained results, demonstrate the obvious changes in TPS serum level in patients underwent various treatment procedures.
 Conclusion: The results have revealed that the serum TPS is not only as a measure of prognosis but also would be helpful in follow up and treatment control of the disease. Moreover the results has shown that serological analysis can be settled in the diagnosis and follow up with production of polyclonal antibody against TPS gene family and planning appropriate pattern.

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Background: Inhibin is a dimeric glycoprotein that has a depressive effect on the anterior hypophys secretion. The level of this tumor marker is undetectable in menopause women. In patients with gynecological cancer, especially granulosa and epidermal-type (mucinous), ovarian cancers considerable increase in the serum level of inhibin has been reported. The increased level of inhibin has been reported in patients with recurrent ovarian cancer. Methods: We measured total serum inhibin and CA125 tumor marker level in 38 postmenopausal women with pathologically confirmed ovarian cancer before and after surgery out of 51 suspected women. Our control group were postmenopausal women that attended to our clinic for routine gynecologic check up. Both tumor markers were measured in these patients too. Results: Among 38 women with ovarian cancer, 13(34.2%) had elevated serum levels of total inhibin. Among the 16 women with serous adenocarcinoma, 3 patients (18.8%) had elevated serum levels of inhibin. All the three women with granulosa cell tumor had elevated serum levels of inhibin (100%) and 3 of 4(75%) women with mucinous ovarian cancer had the same result. three out of 38 women in control group had elevated serum levels of inhibin. Among all 38 patients, 6(15.7%) showed tumor recurrence, that all were concomitant with rising of both serum CA125 and Inhibin levels (p=0/001). Conclusions: Serum inhibin level is a usefull tumor marker in granulosa cell and in mucinous tumor of ovary. In this study combined inhibin and CA125 assay showed better results in early detection of ovarian cancer in comparison to either CA125 or inhibin alone

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Background: Endometrial carcinoma is considered the most common gynecological cancer in the world. Pelvic and para-aortic lymphadenectomy is widely advised based on FIGO staging system. The purpose of this study was to determine whether the biomarker human epididymis protein 4(HE4) correlates with depth of myometrial invasion, histologic grade and metastases in patients with endometrioid adenocarcinoma of the uterus. Methods: This was a cross-sectional study in women with biopsy-proven endometrioid adenocarcinoma in the gynecological ward of Vali-e-Asr Hospital from October 2012 to October 2014. The concentrations of HE4 and CA125 were assessed before surgery and all surgical specimens were reviewed by dedicated gynecologic pathologists. The results were compared with the final histopathology report. Results: A total of 80 patients were initially entered in this study. Twelve patients were excluded because they didn’t have tumor marker. Most of patients (76%) was in stage I disease. Levels of serum HE4 greater than 140 PM and CA125 greater than 35 kU/L observed in 12(17%) and 26(38.2%) of patients, respectively. Of the 52 patients with satge I, 14(26.9%) had CA125&ge35 KU/L, compared with 6(66.7%) of the 9 patients with stage II and 6(85.7%) of the 7 patients with stage III (P<0.002). A significant increase in serum CA125 level was noted in patients with grade III tumors, deep myometrial invasion, cervical stromal involvement and nodal metastasis (P<0.001, P<0.0001, P<0.006, P<0.002). Among the group of patients with early stage disease a significant increase in serum CA125 was noted in patients with deep myometrial invasion. Five out of 52 patients (9.6%) in stage I had HE4 level&ge140 PM, compared with 3 patients (33.3%) with stage II and 4 patients (57.1%) with stage III disease (P<0.003). A significant increase in serum HE4 level was noted in patients with grade III tumors, deep myometrial invasion, cervical stromal involvement and nodal metastasis (P<0.035, P<0.001, P<0.012, P<0.007). Conclusion: Human epididymis protein 4 (HE4) and CA125 may be a useful markers preoperatively in the clinical decision making for determining the need for lymph node dissection in women with endometrial cancer.

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Results: According to the area under the ROC curve, regardless of the patients' menopausal status, the highest diagnostic value was dedicated to RMI with 89% under the curve area and 95% confidence interval (81.6-96.4%). Diagnostic values of other markers were as the following: 87.7%(95%CI=80.3-95%) for HE4, 87.3(95%CI=79.1-95.4%) for CA125, and 86.2%(95%CI=78.7-93.6%) for ROMA. In terms of menopausal status, HE4 had the highest diagnostic value in premenopausal patients, while in the menopausal group CA125 had the highest diagnostic value.