Oncofoetal antigens in cancer of the cervix and ovary

The incidence of oncofoetal antigens has been reported to be increased in patients with gynaecological cancers. In this study the incidence of CEA, AFP, and hCG (beta subunit) were studied in patients with adenocarcinoma of the ovary, adenocarcinoma of the cervix, and squamous-cell carcinoma of the cervix. Using a low cut-off point (CEA 2.5 microgram/l, AFP 5 microgram/l, and hCG 3 i.u./l) there is an unacceptably high proportion of control patients having one or more positive tests (42-54%) compared to cancer-bearing patients (67%). The specificity of the tests can be increased to over 95% by increasing the cut-off point to CEA 10 microgram/l, AFP 10 microgram/l, and hCG 10 i.u./l). Although this reduces the sensitivity considerably, the incidence of false positives in the control population is reduced to nil in non-cancer patients and to 2% in cancer patients tested when free of tumour, compared to 17% of patients with cancer of the ovary, 33% with adenocarcinoma of the cervix, and 6% with squamous-cell carcinoma of the cervix. Patients with adenocarcinoma of the cervix were clearly distinguishable from those with squamous-cell carcinoma of the cervix by these tests. There was also a significant correlation between AFP and hCG levels in adenocarcinoma of the cervix (r = 0.53, P less than 0.05).