Serum alpha L-fucosidase enzyme activity in ovarian and other female genital tract tumors

Objectives: To assess the value of serum alpha-L-fucosidase as a tumor marker in the diagnosis of ovarian and other female genital tract tumors. Methods: One-hundred fifty-one patients were studied; 101 had different genital tract tumors (malignant ovarian tumors (48), carcinoma of the cervix (13), endometrial carcinoma (6), carcinoma of the vulva (6) and benign tumors (28)), A control group of 50 healthy female patients was included. Serum alpha-L-fucosidase activity was determined in all patients and controls. Serum CA 125 level was also determined in patients with malignant ovarian tumors. Results: Patients with malignant ovarian tumors showed the lowest level of alpha-L-fucosidase activity in comparison to other malignant and benign tumors of the female genital tract and also in comparison to control group. The majority of ovarian carcinoma patients (90%) had a serum level of < 275 u/ml of alpha-L-fucosidase activity, while more than 90% of the control group and other genital tumors had a serum level of > 275 u/ml. The sensitivity and specificity of serum alpha-L-fucosidase activity in diagnosing epithelial ovarian tumors were 88.5% and 98%, respectively (using a cut-off level of < 275 u/ml). The corresponding figures for CA 125 were 96.2% and 100% (using a cut-off level of > 35 u/ml). Conclusions: Serum alpha-L-fucosidase enzyme activity can be useful as a tumor marker in diagnosing advanced malignant epithelial ovarian tumors. Its sensitivity and specificity are comparable to CA 125. However, there is lack of data to support its usefulness in the diagnosis of early stage disease (Stage 1). The cost of doing the test is one-third that of CA 125 and the test can be more widely applied in developing countries. Copyright (C) 1996 International Federation of Gynecology and Obstetrics.