A comparative study of immunosuppressive acidic protein (IAP), CA 125 and acute-phase proteins as parameters for ovarian cancer monitoring.

The serum concentrations of immunosuppressive acidic protein (IAP), CA 125, alpha-1-antitrypsin (AL-1-AT), C-reactive protein (CRP) and ceruloplasmin (COP) were determined in 63 patients with ovarian carcinoma (mean age 56.9 +/- 11.1 years). The threshold value of IAP was 640 micrograms/ml (means + 2SD), of CA 125 35 U/ml, of AL-1-AT 4 mg/ml, of CRP 12 micrograms/ml, and of COP 600 ng/ml. Eighty-three analyses of the patients with ovarian cancer coincided with tumor progression and 124 samples with remission. In women with progressive ovarian carcinoma the median IAP serum concentrations (799.3 +/- 292 micrograms/ml) were significantly increased as compared to the values of the healthy control group (48 volunteers, mean age 37.8 +/- 13.8 years; IAP 452.0 +/- 146.0 micrograms/ml). The median serum concentrations of IAP (799.3 +/- 292.2 micrograms/ml), CA 125 (933.8 +/- 1442.1 U/ml). AL-1-AT (3.8 +/- 8.7 mg/ml), CRP (31 +/- 39 micrograms/ml) were significantly elevated with progression as compared to remission (IAP 511.8 +/- 111.9 micrograms/ml, CA 125 18.4 +/- 14.4 U/ml, AL-1-AT 2.8 +/- 4.1 mg/ml, CRP 13 +/- 11 micrograms/ml). This was not the case with COP (509 +/- 761 vs. 466 +/- 106 ng/ml). A correlation between increased serum values and confirmed tumor progression was encountered in 65.1% of the patients for IAP, in 80.7% for CA 125 and in 34.9% for CRP and AL-1-AT. 98.8% false negative serum values were found for COP. Seven out of 16 and 4 out of 16 CA 125 negative samples showed right positive IAP and right positive CRP and AL-1-AT values, respectively. 88.7% of the IAP values, 92.7% of the CA 125 values, 71% of the AL-1-AT values, 93.5% of the CRP and 100% of the COP values were right negative. Our results indicate that the simultaneous determination of CA 125 and IAP enhance the efficiency of tumor monitoring in patients with ovarian cancer.