{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:53:16Z","timestamp":1785873196678,"version":"3.56.0"},"reference-count":23,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objective: Tumor biomarkers are widely used in adult oncology, but their diagnostic value in pediatric patients remains unclear. This study aimed to evaluate the clinical significance of CA-125, CA 19-9, CA 15-3, and CEA in children evaluated for suspected malignancy. Methods: This retrospective study included 211 pediatric patients (0\u201318 years) referred to a tertiary pediatric oncology center. Serum levels of the four biomarkers were analyzed in relation to patient demographics, imaging findings, and final diagnoses. Statistical analyses included chi-square, Mann\u2013Whitney U, Kolmogorov\u2013Smirnov tests, and receiver operating characteristic (ROC) curve analysis. Results: Of the 211 patients, 35 (16.6%) were diagnosed with malignancy. Elevated CA-125 was significantly associated with malignancy (p = 0.002), particularly among postpubertal female patients. Imaging abnormalities were more frequent in CA-125\u2013positive cases (p &lt; 0.001) and in patients with confirmed malignancy. ROC curve analysis demonstrated that CA-125 had an area under the curve (AUC) of 0.642, indicating modest discriminatory power. No significant associations were found for CA 19-9, CA 15-3, or CEA. Conclusions: CA-125 may serve as an adjunctive diagnostic biomarker in pediatric oncology, particularly in postpubertal girls and when interpreted alongside imaging findings. Other markers showed limited diagnostic value. Given its low sensitivity, CA-125 is not suitable as a standalone screening test in children. Larger, multicenter prospective studies are needed to establish pediatric-specific reference ranges and validate these findings.<\/jats:p>","DOI":"10.3390\/diagnostics16010054","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T11:22:14Z","timestamp":1766575334000},"page":"54","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic Value of CA-125 and Other Tumor Biomarkers in Children with Suspected Malignancy: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0008-303X","authenticated-orcid":false,"given":"\u015eule","family":"\u00c7al\u0131\u015fkan Kam\u0131\u015f","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Adana City Education and Research Hospital, Adana Faculty of Medicine, University of Health Sciences, 01370 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7373-4986","authenticated-orcid":false,"given":"Metin","family":"\u00c7il","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Adana City Education and Research Hospital, Adana Faculty of Medicine, University of Health Sciences, 01370 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1316-4501","authenticated-orcid":false,"given":"Beg\u00fcl","family":"Ya\u011fc\u0131","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Adana City Education and Research Hospital, Adana Faculty of Medicine, University of Health Sciences, 01370 Adana, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1515\/cclm-2022-1090","article-title":"Clinical usefulness of circulating tumor markers","volume":"61","author":"Filella","year":"2023","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Lokshin, A., Bast, R.C., and Rodland, K. (2021). Circulating cancer biomarkers. Cancers, 13.","DOI":"10.3390\/cancers13040802"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4","DOI":"10.14740\/wjon1425","article-title":"Carcinoembryonic antigen, carbohydrate antigen 19-9, cancer antigen 125, prostate-specific antigen and other cancer markers: A primer on commonly used cancer markers","volume":"14","author":"Desai","year":"2023","journal-title":"World J. Oncol."},{"key":"ref_4","first-page":"211","article-title":"Childhood and adolescent cancer statistics, 2019","volume":"69","author":"DeSantis","year":"2019","journal-title":"CA Cancer J. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1002\/cncr.28748","article-title":"Declining childhood and adolescent cancer mortality","volume":"120","author":"Smith","year":"2014","journal-title":"Cancer"},{"key":"ref_6","first-page":"73","article-title":"Biomarker research and clinical trials in pediatrics: Progress and pitfalls","volume":"495","author":"Lippi","year":"2019","journal-title":"Clin. Chim. Acta"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jpedsurg.2019.09.062","article-title":"Understanding the value of tumor markers in pediatric ovarian neoplasms","volume":"55","author":"Lawrence","year":"2020","journal-title":"J. Pediatr. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Ueda, A., Yuki, S., Ando, T., Hosokawa, A., Nakada, N., Kito, Y., Motoo, I., Ito, K., Sakumura, M., and Nakayama, Y. (2024). CA125 kinetics as a potential biomarker for peritoneal metastasis progression following taxane-plus-ramucirumab administration in patients with advanced gastric cancer. Cancers, 16.","DOI":"10.3390\/cancers16050871"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.ygyno.2009.09.041","article-title":"Current state of biomarker development for clinical application in epithelial ovarian cancer","volume":"116","author":"Moore","year":"2010","journal-title":"Gynecol. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/S0140-6736(15)01224-6","article-title":"Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): A randomised controlled trial","volume":"387","author":"Jacobs","year":"2016","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Birbas, E., Kanavos, T., Gkrozou, F., Skentou, C., Daniilidis, A., and Vatopoulou, A. (2023). Ovarian masses in children and adolescents: A review of the literature with emphasis on the diagnostic approach. Children, 10.","DOI":"10.3390\/children10071114"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1210\/er.2002-0019","article-title":"The timing of normal puberty and the age limits of sexual precocity: Variations around the world, secular trends, and changes after migration","volume":"24","author":"Parent","year":"2003","journal-title":"Endocr. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1159\/000338393","article-title":"Tumor markers in clinical practice: A review focusing on common solid cancers","volume":"22","author":"Duffy","year":"2013","journal-title":"Med. Princ. Pract."},{"key":"ref_14","unstructured":"(2023). Elecsys CA 125 II, CA 19-9, CEA, and CA 15-3 II Immunoassays: Method Sheet, Roche Diagnostics GmbH."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.21037\/atm.2017.05.13","article-title":"Circulating biomarkers in epithelial ovarian cancer diagnosis: From present to future perspective","volume":"5","author":"Montagnana","year":"2017","journal-title":"Ann. Transl. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.gore.2018.07.002","article-title":"Standard and optimal cut-off values of serum CA-125, HE4 and ROMA in preoperative prediction of ovarian cancer in Vietnam","volume":"25","author":"Huy","year":"2018","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s13052-023-01508-6","article-title":"Clinical value of combined serum CA125, NSE and 24-hour urine VMA for the prediction of recurrence in children with neuroblastoma","volume":"49","author":"Li","year":"2023","journal-title":"Ital. J. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e14577","DOI":"10.1097\/MD.0000000000014577","article-title":"Assessment of the diagnostic value of using serum CA125 and GI-RADS system in the evaluation of adnexal masses","volume":"98","author":"Zheng","year":"2019","journal-title":"Medicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3097","DOI":"10.21037\/gs-21-666","article-title":"Modified HE4, CA125, and ROMA cut-off values and predicted probability of ovarian tumor in Chinese patients","volume":"10","author":"Zhao","year":"2021","journal-title":"Gland Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13048-019-0503-7","article-title":"Biomarkers and algorithms for diagnosis of ovarian cancer: CA125, HE4, RMI and ROMA, a review","volume":"12","author":"Dochez","year":"2019","journal-title":"J. Ovarian Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Doculara, L., Trahair, T.N., Bayat, N., and Lock, R.B. (2022). Circulating tumor DNA in pediatric cancer. Front. Mol. Biosci., 9.","DOI":"10.3389\/fmolb.2022.885597"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"20406","DOI":"10.1038\/s41598-023-47796-0","article-title":"Exploration of the molecular mechanism of intercellular communication in paediatric neuroblastoma by single-cell sequencing","volume":"13","author":"Chu","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.htct.2024.04.043","article-title":"Evaluation of the association of tumor biomarkers with childhood cancers","volume":"46","year":"2024","journal-title":"Hematol. Transfus. Cell Ther."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/1\/54\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:11:02Z","timestamp":1766725862000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/1\/54"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,23]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["diagnostics16010054"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16010054","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,23]]}}}