tailieunhanh - Physiologic variations of serum tumor markers in gynecological malignancies during pregnancy: a systematic review

The all-too-common conditions this woman and her children face illustrate how health programs and weak systems in many developing countries are not meeting needs. Although health services may be available, too often they are of poor quality and are provided in an uncoordinated or ad hoc manner. Often, they are organized around funding sources or diseases, rather than in a way that addresses the broader needs of the populations they seek to serve. President Obama’s Global Health Initiative addresses the challenges faced by this woman and her family – and mil- lions of others in similar circumstances. GHI serves as the. | Han et al. BMC Medicine 2012 10 86 http 1741 -7015 10 86 Clinical Biomarkers BMC Medicine RESEARCH ARTICLE Open Access Physiologic variations of serum tumor markers in gynecological malignancies during pregnancy a systematic review Sileny N Han1 Anouk Lotgerink2 Mina Mhallem Gziri3 Kristel Van Calsteren3 Myriam Hanssens3 and Frédéric Amant1 Abstract Background Recent insights provide support for the treatment of cancer during pregnancy a coincidence that poses both mother and fetus at risk. Our aim was to critically review studies on the physiologic variations during pregnancy the most common tumor markers used in diagnosis and follow-up of gynecological cancers. Methods We conducted a systematic review of six tumor markers during normal pregnancy carbohydrate antigen CA 15-3 breast cancer squamous cell carcinoma antigen cervical cancer and CA 125 anti-Mullerian hormone inhibin B and lactate dehydrogenase ovarian cancer . Results For CA 15-3 to of all measurements were above the cut-off maximum 56 U mL in the third trimester . Squamous cell carcinoma antigen values were above cut-off in and of the measurements maximum qg L in the third trimester . Up to 35 of CA 125 levels were above cut-off levels were highest in the first trimester with a maximum value up to 550 U mL. Inhibin B anti-Mullerian hormone and lactate dehydrogenase levels were not elevated in maternal serum during normal pregnancy. Conclusion During normal pregnancy tumor markers including CA squamous cell carcinoma antigen and CA 125 can be elevated inhibin B anti-Mullerian hormone and lactate dehydrogenase levels remain below normal cut-off values. Knowledge of physiological variations during pregnancy can be clinically important when managing gynecological cancers in pregnant patients. Keywords anti-Mullerian hormone CA 125 CA 15-3 cancer human epididymis secretory protein 4 HE4 inhibin B lactate dehydrogenase pregnancy squamous-cell carcinoma antigen