Measurement of serum
tumor markers [
lactate dehydrogenase (LDH),
alpha-hydroxybutyrate dehydrogenase (HBD),
LDH-4, erythrocyte sedimentation rate (ESR),
carcinoembryonic antigen (CEA),
beta 2-microglobulin (beta 2M) and CA 125] was done before and after operation, and during the course of
chemotherapy in 43 patients with advanced primary
ovarian cancer. Pre-operative positive results for these serum
tumor markers were 94.4% for CA 125, 62.2% for beta 2M, 54.8% for HBD, 51.3% for ESR and 46.5% for LDH, respectively. In a group of patients from whom most of the
tumor mass had been removed, LDH,
LDH-4 and HBD significantly declined after the operation, whereas in a group of patients with a large
residual tumor after operation no significant change in any of the serum
tumor markers examined was observed after operation. Except for CEA, all serum
tumor markers in patients with complete response to
chemotherapy significantly decreased after 3 courses of
chemotherapy. From the analysis of predictive values for the recurrence of
ovarian cancer, the most reliable
tumor markers as a single marker appeared to be CA 125 and CEA, followed by ESR, LDH and
LDH-4. However, in about 10% of cases, abnormal levels of CA 125 or CEA before treatment returned to the normal range
after treatment and an increase in the other
tumor markers was observed with a relapse of disease in the absence of an increase in CA 125 or CEA. These results suggest that in addition to such
tumor markers as CA 125 or CEA, a combination assay of several
tumor markers is necessary for monitoring of treatment of
ovarian cancer.