Is There a Role of Elevated CA 19-9 Levels in the Evaluation of Clinical
Characteristics of Mature Cystic Ovarian Teratomas? A Systematic Review
and Meta-analysis
The role of preoperative CA 19-9 levels in patients with ovarian mature
cystic teratoma (MCT) and the association of elevated levels of the
biomarker with patients' and tumor characteristics were evaluated. Four
electronic databases were searched for articles published up to
September 2019. Trials that evaluated the significance of elevated CA
19-9 in patients with ovarian MCTs and publications with > 20 patients
were considered eligible for inclusion. Seven studies that included 995
patients with an ovarian MCT who were evaluated with elevated (n = 364)
or normal (n = 631) CA 19-9 levels were included. Mean tumor size was
significantly increased in patients with elevated CA 19-9 levels (p =
0.038). The rate of ovarian torsion was significantly increased in the
elevated CA 19-9 group (p = 0.04). The present study highlights the
importance of CA 19-9 as a marker in the diagnosis of MCT, and a
meta-analysis supports that it could raise a high degree of clinical
suspicion of early recognition of torsion and early surgical management
due to complications related to increased size. Nonetheless, the
diagnostic value of CA 19-9 is still limited and CA 19-9 can still serve
only as a supplementary diagnostic tool in patients with MCTs
