Dados do Resumo

Título

Relevance of the CA-125 molecular marker associated with transvaginal ultrasonography for early investigation of ovarian malignant tumors in patients with hereditary predisposition to cancer.

Introdução

Early detection of malignant tumors is essential for successful treatment of many cancers, including ovarian cancer, the eighth most common cancer in Brazil. Populational screening for this tumor is not recommended given its complex development. However, there is an emergent need for protocols to triage high-risk patients, as proposed by FEBRASGO. The combination of molecular markers, ultrasonography and family history could reduce morbidity and mortality rates of this cancer.

Objetivo

Thus, the aim of this study was to analyze the relevance of screening for ovarian tumors through the CA-125 tumor marker analysis associated with transvaginal ultrasonography (TVUSG) as a tool for investigation and early diagnosis in individuals with family history of ovarian or breast cancer.

Métodos

A search was carried out in PubMed, SciELO and Academic Google databases using the descriptors: “Ovarian cancer; Tumor marker CA-125; Early detection”. Forty articles were included, of which eighteen were excluded for lack of association with the main topic and three due to language barrier, resulting in nineteen articles published from 2000 to 2024 included in this work. The selected articles focused on patients with BRCA1/BRCA2 mutations and/or those who had already suggestive signs of ovarian alterations.

Resultados

CA-125 is a non-specific tumor marker, commonly altered in epithelial neoplasms. For ovarian tumors, its value is increased in 47% of early-stage cases and in 80% of late-stage cases. The association of the CA-125 tumor marker with TVUSG can increase early detection, and its use is justified mainly in previously screened patients with a family history of cancer associated with the BRCA1 and BRCA2 genes, since 10% of ovarian cancers are hereditary . A study published in 2014 by Menon U, followed 741 women with CA-125 levels above 30 U/ml by performing TVUS for 6.8 years, with 20 (2,7%) of them diagnosed with ovarian cancer over time. The combination of tests shows a positive result for the early detection of ovarian neoplasms which have a 5-year survival rate of 93% when discovered soon. Furthermore, detecting neoplasms at an early stage reduces public health costs, since early diagnosis is associated with less invasive treatment.

Conclusões

Cancer screening as a public health strategy must be cost-effective. Incidence and mortality rates of ovarian cancer and its insidious, silent and non specific symptoms can delay diagnosis and treatment. The combination of the CA-125 tumor marker test with TVUS as a screening method for pre-selected patients would represent a cost-benefit gain, especially regarding the health costs of patients with advanced stages of this pathology.

Palavras Chave

Ovarian cancer; Tumor marker CA-125; Early detection