Tumor markers have been investigated in differentiation of benign and malignant
tumors. We analyzed CA 125 and
vascular endothelial growth factor (
VEGF) levels in serum and cyst fluid in patients with epithelial ovarian
tumors. Serum and
tumor cyst fluid of 50 patients with ovarian epithelial
tumors (7 malignant, 3 bordeline and 40 benign) were assayed for
VEGF by ELISA and CA 125 levels by chemoluminescence. CA 125 serum levels were significantly higher in patients with malignant and borderline
tumors than in patients with benign
cysts (p = 0.0005). CA 125 cyst fluid contents were comparable for malignant, borderline and benign ovarian
tumors (p = 0.39). Significantly higher levels of
VEGF were present in cyst fluid for malignant and borderline
tumors compared with benign
cysts (p < 0.0001); however, serum levels of
VEGF were similar among all patients (p = 0.25). The CA 125 serum levels correlated with matched
VEGF cyst fluid levels (r = 0.44, p = 0.0015). Serum CA 125 and cystic
VEGF were good methods to differentiate benign and malignant epithelial ovarian
tumors. Patients with elevated intracystic
VEGF levels presented significantly higher CA 125 serum levels, although the CA 125 intracystic content overlapped. The angiogenesis and enhancement of vascular permeability induced by
VEGF represents a new hypothesis for the release of the
CA 125 antigen into the circulation in patients with ovarian
epithelial neoplasm.