Gynaecological oncology: CA-125 to CEA ratio: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: CA-125 to CEA ratio

Sample item

A 55-year-old woman has ascites and a pelvic mass. CA-125 is 900 U/mL and CEA is 4 ng/mL. What does the CA-125 to CEA ratio suggest?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. A ratio above 25 favours a primary ovarian origin rather than gastrointestinal metastasis

A CA-125 to CEA ratio greater than 25 supports a primary ovarian (serous) cancer, while a lower ratio suggests a gastrointestinal or other primary with ovarian metastasis. It is an adjunct to imaging and endoscopy and does not replace histology. Here the ratio is 225, so ovarian origin is likely.

Option by option

  • A. It indicates a germ cell tumour

    Germ cell tumours are suggested by AFP, hCG or LDH.

  • B. The ratio has no use in diagnosis

    The ratio is a recognised adjunct in assessment.

  • C. A ratio below 25 favours ovarian origin

    A low ratio suggests a gastrointestinal source.

  • D. A ratio above 25 favours a primary ovarian origin rather than gastrointestinal metastasis (correct)

    Correct. A high ratio favours an ovarian primary.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, A ratio above 25 favours a primary ovarian origin rather than gastrointestinal metastasis. A CA-125 to CEA ratio greater than 25 supports a primary ovarian (serous) cancer, while a lower ratio suggests a gastrointestinal or other primary with ovarian metastasis.

Why is "It indicates a germ cell tumour" not the answer?

Germ cell tumours are suggested by AFP, hCG or LDH.

Why is "The ratio has no use in diagnosis" not the answer?

The ratio is a recognised adjunct in assessment.

Why is "A ratio below 25 favours ovarian origin" not the answer?

A low ratio suggests a gastrointestinal source.

What concept does this question test?

It tests Gynaecological oncology: CA-125 to CEA ratio in OBG. It is an adjunct to imaging and endoscopy and does not replace histology. Here the ratio is 225, so ovarian origin is likely.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: CA-125 to CEA ratio?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.