Tumor Markers for Ovarian Cancer

Author: Courtney Misher, MPH, BS R.T.(T)
Last Reviewed: November 21, 2022

Tumor markers, also called biomarkers, are substances or proteins that are made by a tumor, or by cells in the body responding to a tumor. They can be used as part of a cancer diagnosis.

Why are tumor marker test done?

Tumor markers for ovarian cancer can be found in the blood. They are measured using a blood test. Having a high level of a tumor marker may mean that you have cancer, but by itself, a high tumor marker level is not enough to make a diagnosis. There are non-cancerous conditions that can cause tumor markers to be higher than normal. Also, not everyone with ovarian cancer will have a high tumor marker.

Tumor markers, along with other tests (scans, biopsies, etc.), are used to get information about the tumor that can be used for the treatment process. Such as:

  • Diagnose the cancer.
  • Predict the outcome after diagnosis.
  • Decide which type of treatment(s) will work best.
  • See how well treatment is working.
  • Predict how likely it is for the cancer to return after treatment.

What do the tumor marker levels show?

A decrease in a tumor marker may mean that the treatment is working well. If there is no change or the tumor marker level goes up, this may mean that the treatment is not working or that the cancer has returned. These results must be looked at along with radiology tests, physical exams, and the symptoms you are having.

What are the tumor markers used in ovarian cancer?

There are many different ovarian tumor marker tests, each test looks for a different kind of biomarker. Some of these include:

CA-125 (Cancer antigen 125)

  • The most common ovarian cancer tumor marker test. Used to help in diagnosis, seeing how well treatment is working, and checking if the cancer returns after treatment.

HE4 (Human epididymis protein 4)

  • More sensitive than CA125. Used to measure response to treatment and monitor for recurrence. HE4 tumor markers are common with endometrioid ovarian cancer and are linked to endometriosis and Lynch syndrome.

Alpha-fetoprotein (AFP) and Beta-hCG (Beta Human Chorionic Gonadotropin)

  • Used in ovarian germ cell tumors and for cancer staging, predicting outcomes after diagnosis, and seeing how well treatment worked.

Inhibin A & B

  • A hormone that is normally made by ovarian tissue but may be high in certain types of ovarian cancer (mucinous epithelial carcinoma, granulosa cell tumors). Can be used to see how well treatment worked and monitor for the cancer returning after treatment.

CEA (Carcinoembryonic antigen)

  • Can be higher in ovarian tumors and may be used to see how well treatment worked.

If you have questions about your diagnosis and tumor markers, make sure to talk to your provider.

Ferraro, S., Braga, F., Lanzoni, M., Boracchi, P., Biganzoli, E. M., & Panteghini, M. (2013). Serum human epididymis protein 4 vs carbohydrate antigen 125 for ovarian cancer diagnosis: a systematic review. Journal of clinical pathology, 66(4), 273–281. https://doi.org/10.1136/jclinpath-2012-201031

Hussain, F., Hassan, A., Tunio, A., Borowsky, M., Rotman, M., & Dinu, V. (2005). Gynecologic tumor markers. Updated Aug.

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