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Physiologic variations of serum tumor markers in gynecological malignancies during pregnancy: a systematic review

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Han, Sileny N Lotgerink, Anouk Mhallem Gziri, Mina [UCL] Van Calsteren, Kristel Hanssens, Myriam Amant, Frédéric

BACKGROUND: Recent insights provide support for the treatment of cancer during pregnancy, a coincidence that poses both mother and fetus at risk. Our aim was to critically review studies on the physiologic variations during pregnancy, the most common tumor markers used in diagnosis and follow-up of gynecological cancers. METHODS: We conducted a systematic review of six tumor markers during normal pregnancy: carbohydrate antigen (CA) 15-3 (breast cancer); squamous cell carcinoma antigen (cervical cancer); and CA 125, anti-Müllerian hormone, inhibin B and lactate dehydrogenase (ovarian cancer). RESULTS: For CA 15-3, 3.3% to 20.0% of all measurements were above the cut-off (maximum 56 U/mL in the third trimester). Squamous cell carcinoma antigen values were above cut-off in 3.1% and 10.5% of the measurements (maximum 4.3 µg/L in the third trimester). Up to 35% of CA 125 levels were above cut-off: levels were highest in the first trimester, with a maximum value up to 550 U/mL. Inhibin B, anti-Müllerian hormone and lactate dehydrogenase levels were not elevated in maternal serum during normal pregnancy. CONCLUSION: During normal pregnancy, tumor markers including CA 15.3, squamous cell carcinoma antigen and CA 125 can be elevated; inhibin B, anti-Müllerian hormone and lactate dehydrogenase levels remain below normal cut-off values. Knowledge of physiological variations during pregnancy can be clinically important when managing gynecological cancers in pregnant patients.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2012
Language Anglais
Journal information "BMC Medicine" - Vol. 10, no.1, p. 86 (2012)
Peer reviewed yes
Publisher BioMed Central Ltd. ((United Kingdom) London)
e-issn 1741-7015
Publication status Publié
Affiliation UCL - (SLuc) Service d'obstétrique
MESH Subject Anti-Mullerian Hormone ; Pregnancy Complications, Neoplastic ; Tumor Markers, Biological ; Antigens, Neoplasm ; Breast Neoplasms ; Female ; Genital Neoplasms, Female ; Humans ; Inhibins ; L-Lactate Dehydrogenase ; Pregnancy
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Bibliographic reference Han, Sileny N ; Lotgerink, Anouk ; Mhallem Gziri, Mina ; Van Calsteren, Kristel ; Hanssens, Myriam ; et. al. Physiologic variations of serum tumor markers in gynecological malignancies during pregnancy: a systematic review. In: BMC Medicine, Vol. 10, no.1, p. 86 (2012)
Permanent URL http://hdl.handle.net/2078.1/163321