Which of the following is the most important tumor marker to diagnose carcinoma of ovary?

AIIMS Delhi NO - 2018

Obstetrics & Gynaecology

Easy

Appeared in: AIIMS Delhi NO - 2018

Explanation

CA-125 (Cancer Antigen 125) is a protein produced by mesothelial cells and is the most widely used tumor marker for epithelial ovarian cancer, the most common type.
It is elevated in approximately 80% of women with advanced epithelial ovarian cancer.
Clinically, it is used to help diagnose suspicious pelvic masses, monitor the effectiveness of chemotherapy, and detect cancer recurrence after treatment.

Option A: Serum human chorionic gonadotropin (hCG) is primarily a marker for trophoblastic tumors and certain germ cell tumors of the ovary, not the more common epithelial ovarian carcinomas.
Option C: Human placental lactogen (hPL) is a hormone associated with pregnancy and placental function. It has no established role as a tumor marker for ovarian cancer.
Option D: Serum alpha-fetoprotein (AFP) is a marker for hepatocellular (liver) carcinoma and specific types of germ cell tumors, such as yolk sac tumors.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Tumor markers in gynecological cancers as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in educating patients about the purpose of the CA-125 test, including its limitations. It's important to explain that an elevated level does not automatically mean cancer and that benign conditions can also cause a rise.
When caring for a patient undergoing chemotherapy for ovarian cancer, nurses monitor CA-125 trends. A rising level may indicate treatment failure or recurrence, prompting communication with the oncology team for further evaluation.
What if the patient is premenopausal? In premenopausal women, the CA-125 test is less specific because benign conditions like endometriosis, fibroids, and pelvic inflammatory disease are more common and can elevate the marker. In this case, imaging studies are even more critical for diagnosis.

How to Approach the Question

First, identify the core of the question: it asks for the most important tumor marker for ovarian carcinoma.
Recall or look up the primary associations for each listed tumor marker.
Evaluate Option A (hCG): Associate it with germ cell tumors and pregnancy-related conditions.
Evaluate Option B (CA-125): Recognize this as the standard, most common marker for epithelial ovarian cancer.
Evaluate Option C (hPL): Identify this as a pregnancy hormone, not a cancer marker.
Evaluate Option D (AFP): Link this to liver cancer and other types of germ cell tumors.

Concept Tested & Keywords

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