CA125-producing adenocarcinoma of the seminal vesicle

A case of primary seminal vesicle carcinoma is reported. The tumor was a CA125-producing adenocarcinoma consisting of fine papillary-tubular, intricate branching or anastomosing glandular structures and was composed of small cuboidal, but occasionally hobnailed, cells with mostly clear, but occasionally granular, cytoplasm. Some tumor cells showed evidence of secretion of seromucinous materials into the interpapillary and cystic space. lmmunohistochemically, almost half of the tumor cells expressed a positive reaction with anti-CAl25, a common serological marker for ovarian epithelial carcinomas; however, no tumor cells expressed any other serological tumor markers such as carcinoem-bryonic antigen, α-fetoprotein, human chorionic gonadotropin, prostatic specific acid phosphatase, or prostatic specific antigen. The patient showed a high level of serological CA125, which fluctuated parallel with the growth, removal and recurrence of the tumor. The morphological and immunohistochemical findings suggested a close relationship between the present tumor and clear cell carcinoma of the ovary, which is thought to be of a Müllerian-Wolfian duct origin.     

Increased oestradiol level in seminal plasma in infertile men

Seminal hormonal patterns in fertile and infertile men wereinvestigated. Follicle-stimulating hormone (FSH), luteinizinghormone (LH), prolactin, testosterone and oestradiol were assessedby radioimmunoassay, and dehydroepiandrosterone sulphate (DHAS)by bioluminescence assay, on blood and seminal plasma of 23fertile men and 83 infertile men. For fertile men, mean FSH,LH, testosterone and DHAS concentrations were lower and meanoestradiol was higher in seminal than in blood plasma; prolactindid not differ. For infertile men, mean seminal FSH and LH showeda moderate but significant increase compared with fertile men;testosterone, DHAS and prolactin did not differ but mean seminaloestradiol was significantly increased. Of the infertile men,53% had seminal oestradiol concentration above the 90^th percentilevalue for fertile men. The meaning of this seminal oestradiolincrease is unclear since it is not known whether it is thecause or the consequence of the alteration of spermatogenesisin infertile men. Further studies are required to explore thepossible therapeutic implications.     

CA 125 in peritoneal fluid from patients with endometriosis.

This study was performed to evaluate CA 125 in peritoneal fluid as an indicator of endometriosis. Peritoneal fluid from patients with mostly minimal and mild endometriosis (n = 43) and normal controls (n = 17) was collected at laparoscopy or laparotomy. The median concentration of CA 125 in peritoneal fluid did not differ significantly between patients and controls (79 IU/ml versus 76 IU/ml). In patients with endometriosis, a significantly increasing concentration of CA 125 in peritoneal fluid was seen from the early follicular to the late luteal phase; a similar change was not observed in the controls. In 14 patients, peritoneal fluid was sampled again after treatment with danazol and a significant reduction in median CA 125 concentration (76.5 IU/ml versus 57 IU/ml), peritoneal fluid volume (17.5 ml versus 10.5 ml) as well as reduced endometriosis scores (4 versus 2) were found. In controls, the concentration of CA 125 was about 10 times higher in peritoneal fluid than in serum. As the peritoneal levels of CA 125 did not differ significantly between patients with endometriosis and controls and as the reduction seen after danazol treatment did not correlate with the decrease of endometriotic implants, it is concluded that the monitoring of CA 125 in peritoneal fluid will not be useful in the diagnosis or control of endometriosis.     

Serum CA 125 in a pregnancy generated by ovum donation

Serum CA 125 was measured by radioimmunoassay during the firsttrimester at intervals of 2 weeks in a woman with Turner‘ssyndrome, who conceived following ovum donation from a healthyanonymous donor. Serum CA 125 concentrations were lower thanor at the 10th percentile of the normal range. These findingsimply that CA 125 may be secreted from the ovary in the firsttrimester, or produced at another site in response to stimulifrom the ovary     

Pregnancy-associated CA125 antigen as mucin: evaluation of ferning morphology

CA125 antigen is a high molecular mass, structurally heterogeneous, mucin-type molecule expressed during embryonic development as well as in adult human tissues. This study was aimed at investigating its mucin-related property of ferning, as a general complementary way of characterization. Pregnancy-associated CA125 antigen (pCA125) was examined using light, transmission and scanning electron microscopy and compared with cancer-derived CA125 antigen (cCA125). The results obtained for spread-out, air-dried pCA125 and cCA125 samples revealed clear differences in the patterns of crystalline as well as amorphous material. Thus, the fern-like crystals were mainly sparsely distributed and their morphology was atypical. The extent of crystallization of pCA125 was moderately lower than that of cCA125 antigen, whereas variation in the size and spatial organization of fern crystals was evident. Besides the material with a crystalline appearance, differences in the organic substrate were also noticeable. In contrast to the sponge-like appearance of pCA125, cCA125 had a more compact structure. These initial data may be relevant for relating biochemical properties of CA125 antigen with its morphology as a basis for elucidating its still obscure function under different physiological conditions.     

Peripheral CA 125 levels in patients with uterine fibroids.

CA 125, a marker of ovarian cancer, is also increased in otherwise normal women suffering from, for example, pelvic inflammatory disease, endometriosis and adenomyosis. The tissues suspected of producing CA 125 in normal women include the endometrium, the ovary and the peritoneum. This study was based on the hypothesis that uterine myomata would distend the peritoneum covering the uterus and thereby increase the peripheral levels of CA 125. To verify this hypothesis we measured CA 125 by an immunoradiometric assay in eight normal women every second day throughout the cycle and in 26 women with uterine fibroids before and after hysterectomy and at 8 and 12 weeks during gonadotrophin releasing hormone (GnRH) analogue therapy. In normal women no difference was observed between CA 125 levels in the follicular phase or in the luteal phase of the cycle. Over one-third (10/26) of the patients with uterine fibroids had increased (greater than 90th centile of the controls) levels of CA 125 before GnRH therapy or hysterectomy. Removal of the uterus or administration of GnRH significantly decreased peripheral concentrations of CA 125 to levels below those observed in normal women. Furthermore, a significant positive correlation was observed between the levels of CA 125 and the volume of myomata as assessed by ultrasound. We conclude that in those cases of uterine fibroids where CA 125 is increased, monitoring this parameter during GnRH therapy is a good indirect measurement of regression of myomata.     

Sperm motility inhibitor from human seminal plasma: association with semen coagulum

Human seminal plasma contains a sperm motility inhibitor (SPMI)originating from the seminal vesicles as a 52 kDa precursor form that is rapidly degraded by prostatic proteasesafter ejaculation. In this study, the distribution of SPMI biologicalactivity and antigens was analysed in chemically induced, aswell as naturally occurring, arrest of semen liquefaction. SPMIactivity was detected exclusively in the coagulated semen fractionat 2200 ± 560 IU, whereas total seminal plasma proteinsseparated more evenly between soluble and coagulated components(91 ± 19 and 65 ± 18 mg, respectively). An SPMIantiserum recognized different forms of SPMI precursors at 52,38, 35, 33 and 20 kDa in the coagulum while the soluble proteinfraction contained only one major immunoreactive band at 15kDa. High levels of SPMI activity (1500 ± 180 IU/ml)together with high molecular mass forms of SPMI precursor andlow sperm motility (26%) were detected in semen samples thatfailed to liquefy spontaneously at room temperature. Additionof prostatic secretions to the non-liquefying samples causeda decrease of SPMI activity (330 ± 17 IU/ml) and transformedthe SPMI precursor into low molecular mass forms (14–22kDa) with a concomitant increase in sperm motility to 49%. Theresults suggest that SPMI is highly associated with the seminalcoagulum components as very active forms that may adverselyaffect sperm motility when not properly processed after ejaculation.     

卵巢癌和胰腺癌患者血清CA125、CA199的水平相关分析

目的:研究血清CA125和CA199的测定对卵巢疾病和胰腺疾病诊断的临床意义.方法:发光免疫分析测定了50例正常对照组,95例卵巢疾病和67例胰腺疾病患者血清中CA125和CA199的水平.结果:卵巢癌与胰腺癌患者的血清CA125和CA199水平较对照组显著升高(P＜0.001).结论:血清CA125和CA199联合测定对诊断和鉴别卵巢癌和胰腺癌有一定的临床价值.     

The CA 125 tumour-associated antigen: a review of the literature

CA 125 is an antigenic determinant on a high-molecular-weight glycoprotein recognized by a monoclonal antibody which was raised using an ovarian cancer cell line as an immunogen. During the last 5 years the studies reviewed in this paper have provided information concerning the nature, distribution and clinical significance of CA 125. The CA 125 determinant is expressed by epithelial ovarian tumours and various other pathological and normal tissues of Müllerian origin. The function of the glycoprotein expressing CA 125 remains unclear but the distribution of the antigen suggests that it may have a physiological role. The highest serum levels of CA 125 are found in ovarian cancer patients, but elevation of serum CA 125 may also be associated with other malignancies and benign and physiological states, including pregnancy, endometriosis and menstruation. Despite limitations of sensitivity and specificity serum CA 125 estimation is of clinical value in the pre-operative diagnosis and monitoring of ovarian malignancy and may be a prognostic indicator for this disease. The role of CA 125 in screening for early-stage ovarian cancer is currently under investigation. Recent reports suggest that serum CA 125 measurement may also be of value as a prognostic indicator in endometrial cancer and as a reflection of disease status in advanced endometriosis.     

Are pregnancy-associated plasma protein-A (PAPP-A) and CA 125 measurements after IVF-ET possible predictors of early pregnancy wastage?

Pregnancy-associated plasma protein-A (PAPP-A), a macromolecular glycoprotein of placental origin, was reported to be depressed in established ectopic pregnancies. CA 125 is a known marker for ovarian cancer found to be elevated during the first trimester of pregnancy and in women with pelvic inflammatory disease. The present study investigated the usefulness of these parameters to predict the outcome of pregnancy in asymptomatic patients with a positive pregnancy test after in-vitro fertilization and embryo transfer (IVF-ET). Blood samples (n = 159) were obtained at different periods of time post-ET from 39 women, 21 of whom experienced a normal pregnancy, 12 had an intrauterine abortion and six had an ectopic pregnancy. PAPP-A and CA 125 were measured by radioimmunoassays. From day 30 onwards in normal pregnancies, PAPP-A was significantly increased over non-pregnant controls. In the spontaneous abortion group, the levels of PAPP-A were significantly lower than in normal pregnancy but higher than in non-pregnant controls. In ectopic pregnancy, PAPP-A remained at the level of non-pregnant controls throughout the entire observation period. CA 125 was significantly increased in all types of pregnancy. However, in two cases of hyperstimulation followed by a normal pregnancy and in four cases of ectopic pregnancy with signs of peritoneal irritation (hydrosalpinx, ruptured ectopic or salpingitis) the levels of CA 125 were 15-50 times higher than in normal pregnancies.(ABSTRACT TRUNCATED AT 250 WORDS)     

HIV／AIDS患者血清CA199、CA125、CA153检测的临床应用价值

目的研究HIV／AIDS患者血清糖类抗原CA199、CA125、CA153水平的变化，探讨其在HIV／AIDS患者的病情进展及疗效观察中的应用价值。方法对确诊的184例HIV／AIDS患者进行血清CA199、CA125、CA153和CD4＋T细胞的检测，并对检测结果进行比较分析。结果AIDS患者CA199、CA125、CA153值及阳性率显著高于HIV组和HIV／HBV／HCV组及健康对照者（P〈0．05），HIV／HBV／HCV组CA199、CA125、CA153值及阳性率显著高于HIV组和健康对照者（P〈0．05），CD4^＋T细胞数和血清CA199、CA125、CA153水平及异常率呈显著负相关。结论血清CA199、CA125、CA153对于HIV／AIDS的病情诊断及疗效观察具有较好的临床应用价值，建议对HIV感染者应常规进行血清CA199、CA125、CA153水平监测，积极治疗，改善预后。     

CA125 production by the peritoneum: in-vitro and in-vivo studies

The source of CA125 synthesis is still debated. Endometrial, peritoneal, ovarian and amniotic cells have been demonstrated to produce and secrete CA125. Different studies show that the peritoneum is a source of CA125. The present study aimed at investigating in vivo and in vitro the peritoneal contribution to circulating CA125. Cultures of uterine peritoneum, abdominal peritoneum and myometrium explants were performed and CA125 measured in the culture medium. To modulate the potential production of CA125, the explants were cultured with or without cycloheximide, bacterial lipopolysaccharide (LPS) or ascitic fluid. In a prospective study, we compared a group of patients after abdominal surgery (n = 19; nine men, 10 women) with a group after extra-abdominal surgery (n = 21; 11 men, 10 women), in order to detect a postoperative increase of serum CA125. De-novo synthesis of CA125 could not be demonstrated in the cultures of uterine and abdominal peritoneum and in myometrium, but CA125 concentrations were detectable in the culture medium without being modulated by cycloheximide, LPS or ascitic fluid. After peritoneal surgery, the proportion of patients with increased serum CA125 was significantly higher (P < 0.03) after abdominal surgery as compared with extra-abdominal surgery. This is considered as indirect evidence for in-vivo production of CA125 by the peritoneum.     

The effect of hysterectomy on serum CA 125 levels in patients with adenomyosis and uterine fibroids

The human endometrium has been reported to release CA 125 intissue culture, and elevated levels have been found in patientswith endometriosis and adenomyosis. The serum levels of CA 125were measured in 22 women undergoing hysterectomy for adenomyosis(n = 11) or fibroids (n = 11) of the uterus. In 20 patients(91%) the pre-operative CA 125 level was normal (<35 U/ml).All patients with adenomyosis had a normal pre-operative serumCA 125 concentration. Five weeks after the operation the CA125 levels did not differ from the pre-operative levels. Ourresults show that the uterine contribution to the serum CA 125level is minimal, and do not confirm the initial enthusiasmconcerning the possible use of levels as an aid in the diagnosisof adenomyosis.     

Serum levels of CA 125 during the first trimester of normal outcome, ectopic and anembryonic pregnancies

Single serum samples were obtained during the first trimester of pregnancies with a retrospectively normal outcome (n = 150), ectopic pregnancies (n = 38) and anembryonic pregnancies (n = 78). Serial samples during the first trimester were also obtained from 43 women achieving pregnancy following successful treatment for infertility and with a retrospectively defined normal outcome. Significant variation in serum CA 125 levels in relation to gestational age was observed in pregnancies with a normal outcome (P less than 0.0001). Peak serum CA 125 levels were observed at 6-7 weeks, the mean level at this gestation being 40.1 U/ml (range 31.7-50.7 U/ml) in the normal conception/normal outcome group and 36.5 U/ml (range 25.6-52.0 U/ml) in the assisted conception/normal outcome group. A rise and fall in serum CA 125 levels during the first trimester was observed in 42 of 43 assisted conceptions monitored serially, with peak levels ranging from 7 to 1398 U/ml (median 48.8 U/ml) occurring at 28-61 days (median 45 days) gestation. Mean serum CA 125 levels were higher in the anembryonic pregnancy group at 4-5 and 6-7 weeks gestation than in both normal pregnancy outcome groups (P less than 0.01).     

Transferrin in seminal plasma and in serum of men: its correlation with sperm quality and hormonal status

Transferrin concentrations in the seminal plasma and in serum were measured and correlated with sperm quality (concentration, motility and morphology) and hormonal status (FSH, LH and testosterone) of 75 men aged from 21 to 46 years. A significant positive correlation was found between the seminal plasma concentration of transferrin and the sperm concentration (r = 0.69, P less than 0.0001) and motility (r = 0.39, P less than 0.0001). No other correlations were found. These data confirm that seminal plasma levels of transferrin can be used as a reliable index of sperm quality, and possibly as a Sertoli cell marker.     

Fluctuations in CA 125 and CA 15-3 serum concentrations during spontaneous ovulatory cycles

The aim of this study was to investigate cycle dependent changes of serum CA 125 and CA 15-3 concentrations during spontaneous ovulatory cycles. Twenty apparently healthy women with spontaneous menstrual cycles attending our infertility clinic were included. Of these women, 18 had occluded tubes as a result of sterilization. Ovulation was confirmed by luteinizing hormone test and ultrasonography and, to exclude endometriosis, a laparoscopy was performed. Serum samples for CA 125, CA 15-3, 17 beta-oestradiol and progesterone determinations were taken every second day starting on the 2nd day of the cycle until the 7th day of the next cycle. After correction for inter-individual variation in serum concentrations, highest CA 125 concentrations were found during the menstruation. During the follicular and peri-ovulatory phase CA 125 serum concentrations were lowest. For CA 15-3, serum concentrations were not statistically different throughout the cycle. CA 125 and oestradiol concentrations were negatively correlated, CA 15-3 and oestradiol concentrations were positively correlated. Absolute serum concentrations of both CA 125 and CA 15-3 vary among females. Within the female, fluctuations of CA 125 are phase related. In the population studied most of the patients had tubal obstruction and high CA 125 serum concentrations during menstruation, which revokes the theory that the menstrual rise of CA 125 is due only to retrograde menstruation.     

Relationship of seminal plasma interleukin (IL) -8 and IL-6 with semen quality

The concentration of interleukin (IL) -8 and IL-6 was determined in seminal plasma (SP) samples from 137 randomly chosen subfertile males to evaluate the relationship with other potential parameters of subclinical infection/inflammation such as seminal leukocytes, and with semen quality in a prospective study. All patients were asymptomatic for genital tract infection. A comprehensive semen evaluation included sperm analysis, sperm migration testing, antisperm antibody screening, immunocytochemical round cell differentiation to determine seminal leukocytes counts and the leukocyte ratio, complement fraction C(3) (C(3c)) determination, and semen cultures, in aliquots of the same ejaculates. The SP concentration of IL-8 was inversely related to semen quality, e.g. to the total number of motile spermatozoa or to the outcome of the sperm migration test (motile sperm harvested after a swim-up procedure). IL-8 concentrations were significantly correlated with leukocyte counts per ml (P < 0.0001) and per ejaculate (P < 0.0001), and with the leukocyte ratio (P < 0.001). All leukocytospermic samples had high IL-8 concentrations (< or =2 ng/ml). The SP concentration of IL-6 was much lower, but was significantly correlated with IL-8 (P < 0.0001). Both IL-8 and IL-6 were significantly related with the C(3c). No association of interleukin concentrations with the bacterial colonization of semen samples was found. The results indicate a marked relationship of some pro-inflammatory cytokines with semen quality. The significant association with seminal leukocytes and other potential inflammation markers suggests that IL-8 might be used as sensitive marker for silent male genital tract infection.     

联合检测HE4和CA125对卵巢癌早期评估的价值

为探讨联合检测人附睾蛋白4（HE4）和糖类抗原125（CA125）在卵巢癌早期诊断、治疗中的价值,测定134例女性血清HE4、CA125水平,其中体检健康女性58名,作为正常对照组,盆腔肿物住院患者76例,按术后病理结果分为良性病变组15例,交界性病变组19例和卵巢癌组42例。应用ELISA法检测血清HE4水平,应用全自动化学发光分析系统检测血清CA125水平。全部随访2~62个月。卵巢癌组HE4、CA125水平明显高于其他3组,差异有统计学意义（P〈0.01）,其他3组CA125水平比较差异均无统计学意义（P〉0.05）,交界性病变组HE4水平与良性病变组、正常对照组比较,差异也有统计学意义（P〈0.05）;二者水平在I期与Ⅲ、Ⅳ期之间差异有统计学意义（P〈0.05）;且有淋巴结转移者明显高于无淋巴结转移者（P〈0.05）;随访结果表明,随HE4和CA125水平的差异（P〈0.05）,患者的5年生存率也有显著差异。对临床指标肿瘤长径〉6 cm的HE4水平明显高于肿瘤长径≤6 cm者（P〈0.05）,而两者间CA125水平无显著差异（P〉0.05）。卵巢癌患者HE4和CA125水平呈正相关（r=0.48）。联合检测HE4和CA125对卵巢癌早期诊断,判断恶性程度,评价治疗效果及评估预后均有重要意义。     

肿瘤标志物CA19-9、CA242、CA125在胰腺癌诊断和预后评估中的价值

为了评价CA19-9、CA242、CA125单独或联合检测在胰腺癌诊断和预后评估中的作用,对105例确诊的胰腺癌患者,手术前检测血清CA19-9、CA242、CA125值,并检测了70例非胰腺恶性肿瘤患者和30例良性胰腺疾病患者的血清CA19-9、CA242、CA125水平.结果发现,单独应用于胰腺癌诊断时,CA19-9的灵敏度最高,但是其特异性显著低于CA242和CA125(P＜0.01).联合检测CA125和CA242可使诊断特异性达到92%.CA242高于正常值的胰腺癌患者,其生存期明显短于CA242值正常的胰腺癌患者(P＜0.05).三项肿瘤标志物中两项以上高于正常值的患者,其生存期显著低于仅有一项高于正常值或三项皆正常的患者(P＜0.05).CA19-9在胰腺癌诊断率方面优于CA125和CA242.联合使用CA125和CA242可以提高诊断的特异性.肿瘤标志物高水平与胰腺癌进展期相关.三项肿瘤标志物中两项或三项高于正常值的患者其生存期较短.     

卵巢癌标志物CA125酶联免疫吸附分析法的建立

目的：建立一种血清ＣＡ１２５的临床检测方法。方法：一株ＣＡ１２５单抗用于固相包被，另一株与辣根过氧化物酶偶联制备ＣＡ１２５的酶标记物，以四甲基联苯胺为底物，采用一步法，建立了ＣＡ１２５的酶联免疫吸附分析法。结果；灵敏度为２．００Ｕ／ｍｌ。批内ＣＶ值低于５．３２％，批间ＣＶ值低于７．３９％。