Comparison between soluble tumor necrosis factor receptors and CA125 in peritoneal fluids as a marker for epithelial ovarian cancer.

The levels of the soluble forms of the membrane-bound receptor for tumor necrosis factor (TNF), p55 and p75, were assessed in peritoneal fluid samples from 50 patients with ovarian cancer, from 20 patients operated for benign pelvic masses, and from 26 healthy women undergoing laparoscopy. The 95% cutoff for normal levels were 14.0 and 5.2 ng/ml for p55 and p75, respectively. In patients with active ovarian cancer, elevated levels of p55 and p75 were found in 54 (p55) and 84% (p75) of the patients, and elevated levels were seen in all histologic types. The levels correlated with peritoneal fluid quantity and with stage of disease. Among 20 patients operated for benign pelvic masses, 1 patient had elevated p55 and 8 patients (40%) had elevated p75. The concentration of CA125 in peritoneal fluids showed a 95% cutoff value in healthy individuals of 8.950 U/ml; and elevated CA125 levels were found in 7 patients with ovarian cancer (14%) and in none of the patients with benign masses. The results indicate that in peritoneal fluid, measurement of soluble TNF receptors, and particularly of p75, has an increased sensitivity and accuracy over CA125 in distinguishing ovarian cancer from benign pelvic masses.