[Immunohistochemical demonstration of CA 125, CA 19-9 and CEA in normal and pathologically changed adnexa]

Sections of formalin fixed and paraffin embedded tissue samples from 11 normal ovaries and fallopian tubes, 13 tuboovarian abscesses, 3 carcinomas of the fallopian tube and 105 common epithelial ovarian tumors were examined to demonstrate the morphological background of elevated serum levels of CA 125, CA 19-9 and CEA. 9/13 tuboovarian abscesses were positive for CA 125 and 5/13 for CA 19-9, elevated serum levels of these markers could be explained by the expression of markers in epithelial cells of the inflamed tubes. Serous tumors and undifferentiated carcinomas were CA 125 positive in 86% and 70%, respectively. All mucinous tumors were CA 125 negative; most of them, however, were CA 19-9 positive (77%). CEA was found in endometroid tumors in 44% of the cases. Only one marker was detected in 42% of the borderline tumors and carcinomas. The immunohistochemical detection of a marker indicates its potential usefulness for monitoring. Although we used three tumor markers, 7% of the ovarian malignancies were negative for all markers tested. The marker expression was very heterogeneous: positive areas were directly adjacent to negative areas. There was no specificity for histological type, tumor localization or malignancy, all markers could be detected in some of the benign tumors, CA 125 and CA 19-9 also in inflamed tissue.