Evaluation of the role of preoperative serum ca125 levels in predicting myometrial invasion depth and presence of lymphovascular invasion in patients undergoing surgery for endometrial carcinoma: a retrospective study

This study aimed to assess the predictive role of preoperative serum CA125 levels in determining the depth of myometrial invasion (MI) and the presence of lymphovascular invasion (LVI) in patients undergoing surgery for endometrial carcinoma (EC). A retrospective analysis was conducted on 348 cases treated at our hospital's obstetrics and gynecology clinic between January 2017-2023, including 336 cases of Type 1 EC and 12 cases of Type 2 EC. The study investigated the association between preoperative serum CA125 levels and both the depth of MI and the presence of LVI. Regarding Type 1 EC, a serum CA125 cutoff of >17 demonstrated a sensitivity of %64.2 and specificity of %57.8 in predicting deep MI, showing a statistically significant relationship. Similarly, for LVI prediction in Type 1 EC, a cutoff of >19 had a sensitivity of %53.6 and specificity of %60.1, also significant. For Type 2 EC, a serum CA125 cutoff value of >15 showed a sensitivity of %87.5 and a specificity of %50.0 in predicting MI. However, it was determined that there is no statistically significant relationship between serum CA125 levels and MI in Type 2 EC. Similarly, a serum CA125 cutoff value of>18.5 for Type 2 EC showed a sensitivity of %50 and a specificity of %50 in predicting LVI. It was found that there is no statistically significant relationship between serum CA125 levels and LVI in Type 2 EC. As a result, it was thought that the preoperatively measured serum CA125 value could significantly predict the depth of MI and the presence of LVI in patients with Type 1 EC. In conclusion, preoperative serum CA125 levels significantly predict the depth of MI and the presence of LVI in Type 1 EC patients and could be useful preoperatively for this aim. However predictif values for type 2 EC did not reach statistically significant level. These findings succeed that further prospective studies with larger number of patients are needed to determine the exact value of preoperative level of CA125 for predicting the postoperative prognostic paramaters. Key Words: Endometrial carcinoma (EC), serum CA125, myometrial invasion (MI)