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Cancer Antigen 125 Associated With Multiple Benign and Malignant Pathologies

From the Servicio de Oncología Médica (CM, PE, MP, AS, BC, RC, EC, FB) and Servicio de Bioquímica (MO, TG), Clínica Puerta de Hierro, Hospital Universitario, Madrid, Spain.

Correspondence: Address correspondence and reprint requests to: Pilar España, MD, PhD, Servicio de Oncología Médica, Hospital Universitario Clínica Puerta de Hierro, San Martín de Porres 4, 28035, Madrid, Spain; Fax: 34-91-3730535; E-mail: mpespanas{at}seom.org

Background: Cancer antigen (CA) 125 tumor-associated antigen is a high molecular glycoprotein used for follow-up of epithelial ovarian cancer. The test is often requested as a differential diagnosis in patients with pleural or peritoneal fluid. This study analyzes the prevalence of CA-125 increases in a population of patients attending a general hospital and discusses the possible clinical implications of increased levels.

Methods: On 4 different days, 380 CA-125 assays were performed in randomly selected patients attending our hospital. Serum CA-125 was measured with a commercial enzyme immunoassay, and clinical records were reviewed for assessment of clinical parameters.

Results: Sixty-one patients (16%) had increased CA-125. The pathologies of these patients were heart failure in 9 (14.7%), lung disease 11 (18%), hepatic cirrhosis in 7 (11.4%), malignant tumors in 9 (14.7%), intra-abdominal nonhepatic disease in 6 (10%), previous surgery in 17 (27.8%), and miscellaneous in 2 (3%). Effusions were seen in 34 patients (55.7%).

Conclusions: Our data confirm the variety of benign and malignant pathologies coursing with increased CA-125. Cardiovascular and chronic liver disease were the most frequent diagnoses in patients with increased CA-125; this supports the opinion that CA-125 lacks utility as a marker for malignancy. CA-125 could have a role in the follow-up of cardiovascular, hepatic, and tumoral diseases with serosal involvement.

Key Words: CA-125 • Serum markers • Mesothelial cells • Ovarian cancer • Serosal involvement

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