World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://wjon.elmerpub.com

Original Article

Volume 000, Number 000, July 2026, pages 000-000

Tumor Marker Heterogeneity in Ovarian Cancer: Clinical Implications of Pretreatment Monitoring of Serum Biomarkers for Recurrence Prediction

↓ Figure 1. Variation in serum levels of biomarkers CA-125 (a), CEA (b), and LDH (c) across all ovarian tumor subtypes in 120 patients. CA-125: cancer antigen 125; CEA: carcinoembryonic antigen; LDH: lactate dehydrogenase.

↓ Figure 2. The relationship between pretreatment serum levels of CA-125, CEA, and LDH and prediction of time to recurrence after treatment. PFS: progression-free survival.

↓ **Table 1.** Clinical Characteristics of Patients With Ovarian Cancer in Our Study
Category	Frequency (n)	Percent (%)
CA-125, CEA, and LDH are laboratory-defined biomarkers; data were available for 120 of 126 patients. SD: standard deviation; CA-125: cancer antigen 125; CEA: carcinoembryonic antigen; LDH: lactate dehydrogenase; FIGO: International Federation of Gynecology and Obstetrics.
Age (years), mean ± SD	53.17 ± 15.47
Histopathological diagnosis
Dysgerminoma	1	0.8
Endometrioid ovarian carcinoma	17	13.5
Granulosa cell tumor	4	3.2
Immature teratoma	2	1.6
Mucinous ovarian carcinoma	19	15.1
Serous ovarian carcinoma	58	46.0
Metastatic tumor to the ovary	25	19.8
FIGO tumor stage
I	25	19.8
II	13	10.3
IIb	1	0.8
IIIa	7	5.6
IIIb	56	44.4
IIIc	24	19.0
Tumor grade
High	72	57.1
Low	17	13.5
Not graded	37	29.4
Baseline CA-125 level^a
High (> 35 U/mL)	92	76.7
Low (≤ 35 U/mL)	28	23.3
Baseline CEA level^a
High (> 5 ng/mL)	16	13.3
Low (≤ 5 ng/mL	104	86.7
Baseline LDH level^a
High (> 250 U/L)	14	11.7
Low (≤ 250 U/L)	106	88.3
Surgery
Optimal	40	33.3
Non-optimal	79	66.7
Follow-up duration, median (range)	18.7 months (range:0–111.3)

↓ Table 1. Clinical Characteristics of Patients With Ovarian Cancer in Our Study

Category

Frequency (n)

Percent (%)

CA-125, CEA, and LDH are laboratory-defined biomarkers; data were available for 120 of 126 patients. SD: standard deviation; CA-125: cancer antigen 125; CEA: carcinoembryonic antigen; LDH: lactate dehydrogenase; FIGO: International Federation of Gynecology and Obstetrics.

Age (years), mean ± SD

53.17 ± 15.47

Histopathological diagnosis

Dysgerminoma

0.8

Endometrioid ovarian carcinoma

13.5

Granulosa cell tumor

3.2

Immature teratoma

1.6

Mucinous ovarian carcinoma

15.1

Serous ovarian carcinoma

46.0

Metastatic tumor to the ovary

19.8

FIGO tumor stage

19.8

10.3

IIb

0.8

IIIa

5.6

IIIb

44.4

IIIc

19.0

Tumor grade

High

57.1

Low

13.5

Not graded

29.4

Baseline CA-125 level^a

High (> 35 U/mL)

76.7

Low (≤ 35 U/mL)

23.3

Baseline CEA level^a

High (> 5 ng/mL)

13.3

Low (≤ 5 ng/mL

104

86.7

Baseline LDH level^a

High (> 250 U/L)

11.7

Low (≤ 250 U/L)

106

88.3

Surgery

Optimal

33.3

Non-optimal

66.7

Follow-up duration, median (range)

18.7 months (range:0–111.3)

↓ **Table 2.** Fully Adjusted Multivariable Cox Proportional Hazards Regression Analysis of Prognostic Factors Associated With Survival in Ovarian Cancer Patients
	Adjusted HR	95% CI	P value
HR: hazard ration; CI: confidence interval; CA-125: cancer antigen 125; CEA: carcinoembryonic antigen; LDH: lactate dehydrogenase; FIGO: International Federation of Gynecology and Obstetrics.
CA-125 high vs low	0.64	0.39–1.04	0.072
CEA high vs low	0.50	0.25–0.98	0.043
LDH high vs low	1.92	1.03–3.56	0.039
Age, per year	1.01	1.00–1.02	0.167
FIGO stage III/IV vs I/II	1.19	0.74–1.89	0.478
High grade vs low/not graded	1.14	0.73–1.78	0.567
Serous vs non-serous histology	0.58	0.37–0.92	0.019
Non-optimal vs optimal surgery	4.79	2.82–8.13	< 0.001
Carboplatin + paclitaxel vs other/no therapy	0.27	0.17–0.44	< 0.001

↓ Table 2. Fully Adjusted Multivariable Cox Proportional Hazards Regression Analysis of Prognostic Factors Associated With Survival in Ovarian Cancer Patients

Adjusted HR

95% CI

P value

HR: hazard ration; CI: confidence interval; CA-125: cancer antigen 125; CEA: carcinoembryonic antigen; LDH: lactate dehydrogenase; FIGO: International Federation of Gynecology and Obstetrics.

CA-125 high vs low

0.64

0.39–1.04

0.072

CEA high vs low

0.50

0.25–0.98

0.043

LDH high vs low

1.92

1.03–3.56

0.039

Age, per year

1.01

1.00–1.02

0.167

FIGO stage III/IV vs I/II

1.19

0.74–1.89

0.478

High grade vs low/not graded

1.14

0.73–1.78

0.567

Serous vs non-serous histology

0.58

0.37–0.92

0.019

Non-optimal vs optimal surgery

4.79

2.82–8.13

< 0.001

Carboplatin + paclitaxel vs other/no therapy

0.27

0.17–0.44

< 0.001