Usually CA125 IS USEFUL FOR EPITHELIAL OVARIAN CANCERS AND NOT OTHER OVARIAN CANCERS WHERE THEN ONE CAN GO IN FOR CA15-3,CA19serie but if one suspects some germ cell tumours one has to go for beta hcg,alfa fetpo protwin ans Ca125 overlaps with ENDOMTRIOSIS AND IS NOT SPECIFIC FOR OVARIAN CANCER BUT IS USE FOR PROGNOSTICATION and for a malignancy whose 5 year survival is so poor why try tojust save in few rs or whatever currency as an accurate diagnosis,staging,mAlignant fluid cytology ,histoogy markers all determine the 5 year survival and i think Ca 125 is cheaper than ca15-3 

Dear Dr. Kulvinder! 

Thanks you for your valuable information!

Best regards!

you are wellcome dr Edlira

CA-125 is a large transmembrane glycoprotein which is encoded by MUC16 gene. In 1981, was first to identify the CA-125 antigen in ovarian carcinoma cell line (OVCA 433) with the development of the OC 125 murine monoclonal antibody which are against cell line OVCA 433. The overexpression of CA-125 was first identified in ovarian carcinoma cell lines using the monoclonal antibody OC125. However, a particular function of CA-125 has yet to be identified either in normal physiology or the development of malignancy.

Since, the level of CA-125 has revealed a number of limitations in different ovarian cancer stages; for women with epithelial ovarian cancer, 80% have CA-125 level up to 35 kU/L with increased level of 50% to 60% in clinically detected stage-I disease, 90% in stage-II, stage-III and IV. In addition, certain factors may alter CA-125 level, like as race / ethnicity, age, hysterectomy, smoking history and obesity.  Although, due to these well-recognized limitations; CA-125 is still recognized as the gold standard and is widely used serum biomarker for ovarian cancer. CA-125 approved by FDA for monitoring disease in patients diagnosed for epithelial ovarian cancer, and it is used for screening ovarian cancer in women (who have a higher risk for BRCA1 mutations) combined with transvaginal ultrasound examination. While, National academy of clinical biochemistry (NACB) panel recommendations for CA-125 in ovarian cancer are; (a) combination with trans-vaginal ultrasound used for early detection in hereditary syndromes, (b) differential diagnosis in suspicious pelvic mass, (c) detection of recurrence, (d) monitoring of therapy, and (e) prognosis.  Also, NACB panel does not recommend CA-125 for screening of ovarian cancer, furthermore, CA-125 not recommended by NACB panel due to lack of sensitivity and specificity for single determination of test for use in screening asymptomatic women .  

While, CA 15-3 is not sensitive or specific enough to be considered useful as a tool for Ovarian cancer screening. Abnormal CA 15-3 antigen levels are found in the serum of most patients with advanced breast carcinoma. Elevations of this marker are less frequently seen in other malignancies. Circulating CA 15-3 levels might be useful in the differential diagnosis of the primary site of cancer. Some studies showed that; In particular, elevated CA 15-3 levels were observed in 70% of patients with metastatic ovarian cancer (but only in advanced stages of Ovarian cancers).

Reference (http://jco.ascopubs.org/content/22/16/3330.full.pdf)

In another study, simultaneous determination of circulating CA 15-3 and CA 125 antigens in 58 patients with cancer of the ovary showed that CA-15-3 is elevated in some cases of ovarian carcinoma with non-elevated CA-125, and that CA-15-3 and CA-125 are distinct antigens. The study concluded that circulating CA 15-3 antigen levels can be found elevated in virtually all types of cancer, particularly when distant metastases are present. Therefore, CA 15-3 levels should not be used in the differential diagnosis of the primary site in patients with metastatic malignancies of unknown origin. Evaluation of CA 15-3 levels may enhance the sensitivity of CA-125 in monitoring the course of ovarian carcinoma.

Reference: (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2246988/) 

Thank you Abdul!

Actually, we use Ca 15-3 to monitor breast cancer therapy  and Ca 125 to monitor  EOC therapy... so biomarker levels show progression or regression of the desease during the treatment.  In fact,  I was interested to know at which degree doctors use it as a prognostic factor during a certain treatment.

what he is trying to add when you know the site of primary that is ocarian epitelial cancer in thise cses yu can use adjuvant ca15-3 for further prognostication of caovary although asically a marker for vbreast cancer but not if there is metastasis disease and site of primary unknownwhere in has no value.

Edlira Paenga, as I already mentioned that both markers are parity-specific and elevated in certain tumors, In fact, it also monitors with BRCA1 and BRCA2 mutation as well as Her2 (when suspected Hereditary or breast cancer). It depends on the baseline (before treatment) and during the course of treatment, whether which one biomarker showed previously higher level (at baseline) and gradually decreasing during the course of treatment.  

i think here we are digressing fro the quetion of Edlira refgarsding Ca125 FROM CA15-3 AS A PROSGNOSTIVC MARKER IN CA OVARY EPITHELIAL TUMOURS.