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Normal pap test, cervical polyp, CA-125 test, elevated 39, transvaginal ultrasound, no masses in ovary. Advice?

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A recent pap test I had came back normal but I also had a cervical polyp removed and it came back "abnormal". In addition, my Doctor wanted to do a repeat CA-125 test (I also had one in April) and both were elevated (39). My transvaginal ultrasound in April didn't show masses in either ovary. I am worried about cancer but all of these tests don't seem to be matching up... Can you recommend next steps. I will be following up with my doctor. I forgot to mention something else, according to my doctor, I also have 2-3 fibroids.
Posted Sat, 21 Apr 2012 in Vaginal and Uterus Health
Answered by Dr. Minoo Bhagia 4 hours later
Hello ,
Thanks for the query.

Cervical polyp can show elevated levels of CA125 but in your case '39' is not very high.

This level gets fluctuated with menstrual cycle , in follicular phase the levels are higher than in the luteal phase.

If there is no tumour in the ovary then it is not significant.

There are other markers also like CA19-9 and CEA which are higher in cervical mucous in women having cervical polyp.

Your Pap's smear is normal that means your cervix is normal but what was written in the report of polyp ?

You have mentioned ' abnormal ' which doesn't specify the nature of the polyp.

You should go for hysteroscopy to see the endometrium and its biopsy if required.

For ovaries you can get CT and MRI done.

Regarding CA125 , you can get the levels repeated , if still abnormal then it is to be reevaluated .

It can increase in breast cancers also.

Any further query is most welcome.
Wishing you good health
Above answer was peer-reviewed by
Follow-up: Normal pap test, cervical polyp, CA-125 test, elevated 39, transvaginal ultrasound, no masses in ovary. Advice? 3 days later
Thank you for your answer. You asked about the nature of the polyp and I have a little more information. The biopsy of the cervical polyp showed mild squamous epithelial dysplasia, CIN 1, arising in atypical squamous metaplasia. The pap smear done this month was normal but he pap smear competed in April was abnormal. I don't know if that means anything.

Again, thank you. If you have any further thoughts, I appreciate it.

Best wishes to you.

Answered by Dr. Minoo Bhagia 9 hours later

Good to hear from you again.

Yes it is an abnormal report, CIN 1 means carcinoma in situ, grade 1 degree.

'In situ ' means it is inside the cells only.

The changes are categorised in the following manner:
1. Normal
2. Atypical
3. Dysplasia
4. Carcinoma in situ
5. Suspicious for invasive cancer.

Atypical squamous metaplasia is usually associated with HPV (human papilloma virus).

Dysplasia is to be taken care of, for that you need colposcopy and biopsy of cervix.

It is better to consult a Gynec-oncologist for complete examination, evaluation and the treatment accordingly.

The changes are still in primary phase of Carcinoma in-situ and can be controlled easily but please do not delay.

Hope this answers your query.

Take care

Wishing you good health.
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