Age-stratified analysis of tumor markers and tumor characteristics in adolescents and young women with mature cystic teratoma.

BACKGROUND: Serum tumor markers are widely used for the preoperative evaluation of an adnexal mass. Elevations of cancer antigen (CA) 125 and CA 19-9 have been reported in patients with mature cystic teratoma (MCT). The aim of the study is to investigate the relation of serum tumor markers with tumor characteristics in young women with MCT.

METHODS: We conducted a retrospective review of 157 patients under the age of 35 who underwent laparoscopic surgery for ovarian MCT. Patients were divided into two age groups: Group I (n = 80): adolescents/young adults (aged 13-25 years) and Group II (n = 77): women aged 26-35 years. Data were analyzed for serum tumor markers, tumor size, and bilaterality.

RESULTS: The rates of elevated CA 125 and CA 19-9 were 10.7% and 31.5%, respectively, for Group I, and 13.9% and 26.5%, respectively, for Group II. The bilaterality rate was higher in Group II compared to Group I (19.5% vs. 8.8%, respectively, p = 0.04). Serum CA 125 and CA 19-9 elevations were not related to tumor size in Group I. In Group II, elevated levels of CA 125 were also unrelated to tumor size. However, significant elevation in CA 19-9 levels was observed when tumor size was larger than 4 cm in this age group (p = 0.004). Elevated CA 125 and CA 19-9 levels were not significantly associated with the presence of bilateral MCT in either group.

CONCLUSION: The results of our study indicate that elevations of CA 19-9 are associated with larger tumor size in women aged 26-35 years, but not in adolescents/young adults. However, elevated serum CA 125 levels are not related to tumor size in either age group.