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| Year:
2016 |
Month:
January
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Volume:
5 |
Issue:
1 |
Page:
4 - 7 |
CA 125 Elevation:
A Descriptive Etiological Study
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Correspondence
Shaheena Appan Parambath, Charu Yadav, Madan Gopal Rajan, Anupama Hegde, Ashok Prabhu, Poornima Ajay Manjrekar, Rukmini Mysore Srikantiah,
Dr. Rukmini Mysore Srikantiah,
Department of Biochemistry, Centre for Basic Sciences,
Kasturba Medical College, Bejai, Mangalore-575004, India.
E-mail: rukmini.shetty@manipal.edu :
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Introduction: CA 125 (Cancer/Carbohydrate antigen 125) is a surface antigen expressed mostly by the ovarian cancer cells. Hence, it is widely used as a tumour marker for detection and monitoring the progression of such cancers. CA 125 is also expressed by cells of different tissues such as pleura, pericardium, Mullerian epithelium, peritoneum etc.
Objective: To identify the different causes leading to elevation of CA 125 and to estimate the elevation of CA 125 in ovarian and non-ovarian causes.
Materials and Methods: A total of 1800 patients testing for CA 125 during the time period January 2011 to December 2013in Kasturba Medical College constituent hospitals, Mangalore were screened. Out of these, OPD patients and in-patients with CA 125 < 35 U/mL were excluded and remaining 236 in-patients were included as the study subjects. Patients were categorized into four groups based on CA 125 level as Group I(35 – 200 U/mL), Group II (201 – 500 U/mL), Group III (501 – 1000 U/mL) and Group IV (>1000 U/mL). To find association of CA 125 with age, patients were stratified into 3 groups based on their age as Group A (15- 35 years), Group B (36-55 years) and Group C (= 56 years). Parameters like age, BP, hemoglobin, CA 125,renal profile and diagnosis of all the patients were evaluated.
Results: Out of 236 patients 54.7% were suffering from malignant ovarian diseases, 31.3% benign ovarian disease, 12% non-gynecological diseases and 2% from gynecological diseases of non-ovarian origin. Mean age for malignancies was 55 ± 10.6 years for benign diseases was 34±12.7 years. Incidence of malignancy among the 4 groups (based on CA 125 level) was 34.4%, 48.8%, 68.7% and 91.6% respectively. Increase in both age and CA 125 levels was highly significant in patients suffering from ovarian malignancies when compared to those with benign ovarian diseases (p<0.001).Difference in CA 125 levels was also statistically significant between malignant and non gynaecological disorders and between benign ovarian and non gynaecological disorders as well (p<0.001).
Conclusion: In spite of higher levels of CA 125 in ovarian carcinoma cases compared to other diagnosis in our data, results confirm the high false positive rate and non-specificity associated with CA 125 as a biomarker as it was seen to increase in numerous other diseases.
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