Predictive effects of preoperative serum CA125 and AFP levels on post-hepatectomy survival in patients with hepatitis B-related hepatocellular carcinoma

The association between the serum levels of cancer antigen 125 (CA125; also termed MUC16) and the prognosis of patients with hepatocellular carcinoma (HCC) has not been widely reported to date. The aim of the present study was to determine the association between preoperative serum CA125 levels and prognosis of patients with hepatitis B virus (HBV)-related HCC after hepatectomy. The study included 306 patients with HBV-related HCC who underwent liver resection and were classified into four subgroups based on their baseline CA125 and α-fetoprotein (AFP) levels. The perioperative clinical data were compared and analyzed. Kaplan-Meier and Cox regression analyses were performed to determine the associations between patient clinicopathological characteristics and survival. The results revealed that the median follow-up time was 35 months. Patients with low preoperative serum CA125 levels presented with improved 3-year disease-free survival (DFS) (79.3 vs. 75.7%; P=0.278) and overall survival (OS) (84.4 vs. 77.1%; P=0.001) rates compared with those among patients with high preoperative serum CA125 levels. High preoperative serum CA125 levels were a risk factor associated with short DFS and OS rates in all patients. In patients with baseline AFP levels >100 ng/ml, low preoperative serum CA125 levels were significantly associated with prolonged DFS and OS rates (log-rank test P=0.002 and P=0.005, respectively). In patients with AFP levels ≤100 ng/ml, no significant differences were observed in DFS or OS rates between the high and low preoperative serum CA125 groups. Patients with high preoperative serum CA125 and AFP levels exhibited the worst prognosis (low DFS and OS rates). In conclusion, high baseline CA125 levels may be associated with a poor prognosis in patients with HBV-related HCC.     

肺癌患者血清CA125检测的临床应用

目的:探讨CA125对肺癌鉴别诊断和观察疗效的临床意义。方法:采用免疫放射分析法测定健康人和按组织学分类的各类肺癌患者血清CA125水平及阳性率,同时检测各样品的血清CEA水平,进行统计分析。结果:患者组较健康对照组CA125水平显著增高(P<0.01)。肺鳞癌组CA125阳性率为84％,腺癌为65％,腺鳞癌为56％,小细胞肺癌为40％;1例大细胞肺癌CA125检测值为230U/ml、CEA值为18ng/mL。肺鳞癌阳性率较其它组x~2检验有显著意义(p<0.01),CA125与CEA呈正相关(R=0.852)。结论:血清CA125可作为对肺癌早期诊断、鉴别诊断及观察疗效的较好参考指标。     

CA125 expression in patients with non-Hodgkin's lymphoma

The present study investigated the possible clinical significance of serum CA125 levels in patients with non-Hodgkin's lymphoma (NHL) and the mechanism of secretion. Serum CA125 levels in 335 patients with NHL were measured by enzyme-linked immunosorbent assay. The tissue CA125 expression in 22 patients with NHL was performed on paraffin section by immunohistochemical methods. One hundred and ninety-eight cases (59.1%) were found to have elevated serum CA125 levels. Serum CA125 levels were associated with clinical stage, effusions, high serum lactate dehydrogenase and beta2-M levels, and response to therapy. Microscopically, immunohistochemical staining revealed that malignant tumor cells demonstrated negative CA125 expression in all of the 22 cases. Our results suggested that serum CA125 levels could be an interesting tumor marker in NHL. The immunohistochemical study suggested that CA125 appeared not to be secreted by lymphoma cells directly.     

Tumour marker antigen CA125 in pancreatic cancer: a comparison with CA19-9 and CEA

CA125 is a tumour marker test based on a monoclonal antibody against an antigen from an ovarian carcinoma cell line. Serum concentrations of CA125 were determined in 95 patients with pancreatic cancer and in 106 patients with benign pancreatic, biliary and hepatocellular diseases. The CA125 concentrations were compared with the CA19-9 and CEA levels. Almost half (45%) of the patients with pancreatic cancer had an elevated CA125 level (greater than 35 U ml-1). Elevated values were also found in benign diseases (24%), especially in patients with pancreatitis and benign hepatocellular diseases, but more seldom in extrahepatic cholestasis. It seems that CA125 is of limited value in the diagnosis of pancreatic cancer. Combination of the CA125 with the CA19-9 test increases the sensitivity only 6% as compared to the CA19-9 assay alone. There may, however, be a use for CA125 in differentiating between obstructive jaundice of benign and malignant origin.     

超声检查与血清CA125检测在卵巢恶性肿瘤诊断中的价值

目的 探讨超声检查与血清肿瘤标志物CA125检测在卵巢恶性肿瘤诊断中的价值。方法 收集我院2012年10月至2013年12月收治的卵巢肿瘤患者113例,其中恶性53例,良性60例,于术前1周内均行超声检查及血清CA125检测。采用倾向得分匹配法（propensity score matching,PSM）均衡组间协变量,获得34对匹配成功的患者并对其诊断结果与病理检查进行比较。结果 CA125检测在卵巢恶性肿瘤诊断中的灵敏性、特异性、阳性预测值（positive predictive value,PPV）、阴性预测值（negative predictive value,NPV）、准确性分别为88.2%、61.8%、69.8%、84.0%、75.0%;超声检查在卵巢恶性肿瘤诊断中的灵敏性、特异性、PPV、NPV、准确性分别为85.3%、88.2%、87.9%、85.7%、86.8%;超声检查联合CA125检测在卵巢恶性肿瘤诊断中的灵敏性、特异性、PPV、NPV、准确性分别为94.1%、64.7%、72.7%、91.7%、79.4%。超声检查单独应用的特异性明显高于CA125检测及二者联合检查的特异性,差异有统计学意义（P均〈0.05）;而灵敏性、PPV、NPV及准确性在两两检查比较中的差异均无统计学意义（P均〉0.05）。结论 CA125检测联合超声检查并不能提高卵巢恶性肿瘤的诊断符合率。     

Serum CA 125 levels in patients with chronic heart failure and accompanying pleural fluid.

Malignant and nonmalignant serosal fluids have been found to be associated with high serum levels of CA 125, suggesting that the presence of fluid in the serosal cavities may stimulate its release. In this study, we investigated the relationship between serum CA 125 levels and the presence of pleural fluid in patients with chronic heart failure (CHF). We performed a clinical study in 36 patients with CHF with and without pleural fluid. Patients with CHF were divided into two groups based on the presence of fluid in the pleural cavity. Group 1 included 18 CHF patients (6 females, 12 males) with pleural fluid. Group 2 consisted of 18 CHF patients (7 females, 11 males) without pleural fluid. The control group consisted of 30 healthy volunteers (12 females, 18 males). The serum CA 125 level was determined in all groups. Serum CA 125 levels were found to be 100.0 +/- 129.4 U/ml in CHF patients with pleural fluids, whereas they were 36.5 +/- 35.2 U/ml in CHF patients without pleural fluid and 8.9 +/- 6.1 U/ml in the control group. Significantly high serum CA 125 levels were found in CHF patients with pleural fluids (p < 0.05) when compared with both CHF patients without pleural fluid and the control group. There was also a statistically significant difference in CA 125 levels between patients without pleural fluid and the control group (p < 0.05). We concluded that serum CA 125 levels should be interpreted with caution in patients with CHF in the presence of pleural fluid. Invasive procedures to define the etiology of elevated serum CA 125 levels may be unnecessary in this patient group.     

Evaluation of serum CA 125 level as a tumor marker in borderline tumors of the ovary

Serum CA 125 was evaluated as a tumor marker in 85 patients with borderline ovarian tumors. Serum CA 125 levels were elevated preoperatively in 18 of 20 (90%) samples (median 66, range 5-272 U ml-1). Preoperative serum CA 125 levels did not correlate to FIGO stage. Preoperative serum CA 125 levels were elevated in seven of nine (78%) with serous tumors (median 131, range 5-272 U ml-1) and in all 11 with mucinous tumors (median 62, range 41-157 U ml-1). There was no significant difference in the CA 125 levels between these two histologic types. Postoperative serum CA 125 levels, measured 3-6 weeks after primary laparotomy, were significantly lower than the preoperative ones (P < 0.001). No difference in the postoperative CA 125 levels was found between those with and those without residual disease after surgery. Postoperative serum CA 125 levels were elevated in eight of 60 (13%) without residual tumor. None of these had relapsed at the time of analysis (26-87 months after surgery). Serum CA 125 levels tended to correlate with disease evolution during chemotherapy. Two with disease remissions had falling levels, one with stable disease had falling level and one with disease progression had rising level. Serum CA 125 samples were obtained before second-look laparotomy in seven patients. Two with negative findings at second-look had normal levels. Of five with positive findings at laparotomy only two had elevated serum CA 125 levels. Disease relapse was associated with elevated serum CA 125 levels in only one of six patients.     

血清CA125水平与淋巴瘤细胞浸润及疗效的关系

目的探讨血清CA125与非霍奇金淋巴瘤(NHL)细胞浸润及患者疗效的关系。方法采用放射免疫学方法测定103例NHL患者的血清CA125水平,并结合临床特征进行分析。结果约49.5%(51/103)的NHL患者血清CA125增高;血清CA125水平与乳酸脱氢酶(LDH)、骨髓浸润、结外侵犯、浆膜腔积液、巨大肿块、CD20高表达相关(P<0.05),CA125增高者化疗完全缓解率(CR)低,且容易复发(P<0.05)。结论血清CA125水平与淋巴瘤细胞浸润有一定相关性,可作为NHL患者诊断、病情进展及复发预测又一重要的辅助指标。     

CA 19-9 and CA 125 levels in the sera of normal blood donors in relation to smoking history

CA 19-9 and CA 125 serum levels were evaluated among smoking and nonsmoking healthy blood donors. Smoking did not elevate mean levels of either CA 19-9 or CA 125 in the sera of 496 of these blood donors from Philadelphia, PA. Mean CA 19-9 levels were slightly higher among females than among males. Among smokers there was a trend toward slightly increasing CA 19-9 serum levels with increased age, which was significant among the male donors. Trends toward slightly decreased mean serum levels of CA 125 among smokers were of borderline significance. Serum CA 19-9 and CA 125 levels in none of these donor subpopulations was elevated compared to levels reported by others for gastrointestinal or ovarian carcinoma patients, respectively. Therefore, smoking status should not interfere with use of either the CA 19-9 or CA 125 assays for diagnostic or monitoring applications.     

甘氨双唑钠(CMNa)联合紫杉醇卡铂化疗对中晚期卵巢癌术后CA125升高的影响

Objective:To investigate the effects of CMNa combined with paclitaxel and carboplatin on elevated CA125 levels in post-operation advanced ovarian cancer patients.Methods:The effects of CMNa combined with paclitaxel and carboplatin on elevated CA125 levels in 25 post-operation advanced ovarian cancer patients were retrospectively analyzed and compared with those in 20 control cases.Results:After 1 cycle of chemotherapy,CA125 levels had decreasing trend compared with control,but had no statistical significance.While after two cycles of chemotherapy,CA125 levels decreased more rapidly compared with those in control.Side effects in two groups were alike.Conclusion:CMNa combined with paclitaxel and carboplatine has a stronger effect on the decrease of elevated CA125 levels than paclitaxel and carboplatin have in the treatment of post-operation advanced ovarian cancer,which indicates that CMNa has chemo-sensitizing effects on chemotherapy of paclitaxel and carboplatin.     

The clinical significance of CA125 in patients with gynecological tumors--a comparative study on CA125 and other tumor markers

Serum CA125 levels were measured by radioimmunoassay patients with various gynecological tumors. Elevated levels of CA125 were detected in the serum of patients with malignant ovarian tumors. Among patients with uterine tumors, CA125 levels were elevated in those with malignant uterine tumors, but not with uterine myomas. The correlations between tumor markers (CA125, IAP, ferritin, PTA) and malignant ovarian tumors were measured, and only CA125 levels were found to correlate with progression or regression of the disease in patients with malignant ovarian tumors. These results suggest that CA125 may be a useful marker for monitoring the response to treatment in patients with malignant ovarian tumors.     

Serum tumor marker CA 125 is an early and sensitive indicator of veno-occlusive disease in children undergoing bone marrow transplantation.

Veno-occlusive disease (VOD) is a potentially lethal complication of patients undergoing bone marrow transplantation (BMT). The diagnosis of VOD is currently based on clinical signs and unspecific laboratory findings. CA 125 is an oncofetal antigen used as a tumor marker in various malignancies, especially in those originating from the female reproductive tract or gastrointestinal organs, whereas serum CA 125 levels are not increased in hematological malignancies. Several pathophysiological alterations occurring in VOD may lead to elevations in serum CA 125 levels. Therefore, we explored the behavior of this marker as a diagnostic tool in VOD. Twenty-nine pediatric transplant patients were studied. Eight patients (28%) developed clinical VOD, and a significant increase in serum CA 125 was noted in all of them. During the 7 days preceding the diagnosis of VOD, an increase of at least 57% in serum CA 125 from the pre-BMT value was observed in 6 (86%) of 7 of the evaluable patients with VOD. In contrast, a similar increase was noted in only 6 of the 21 non-VOD patients during the post-BMT period of 30 days. Accordingly, the sensitivity and specificity of serum CA 125 for predicting or detecting VOD were 86% and 71%, respectively. The serum levels of CA 125 were not affected by the presence of Graft-versus-Host Disease (GvHD) or a septic infection. In conclusion, serum CA 125 is of value as an early marker of VOD in children undergoing BMT.     

Serum CA125: a tumor marker for monitoring response to treatment and follow-up in patients with non-Hodgkin's lymphoma

PURPOSE: Serum CA125 is an important prognostic factor in patients with non-Hodgkin's lymphoma (NHL). Elevation of CA125 level correlates with advanced disease, poor response to treatment, and poor survival rates. The aim of the current study is to evaluate CA125 levels in patients with NHL and to investigate the correlations between high CA125 level and other presenting features. MATERIALS AND METHODS: Thirty-eight patients (14 with low-grade and 24 with aggressive histologically proven NHL) were studied prospectively. Serum CA125 assessment was done at diagnosis, during treatment, and at follow-up. The associations between CA125 levels and other presenting features were examined. RESULTS: CA125 levels were elevated in 43% of patients with low-grade NHL and in 46% of patients with aggressive NHL (i.e., 45% of all patients). A higher CA125 level was associated with advanced disease, bone marrow involvement, extranodal involvement, poor performance status, the presence of B symptoms, and high serum lactate dehydrogenase level. Complete responses occurred in 86% of patients with normal CA125 levels and in 59% of patients with elevated CA125 levels. In both low-grade and aggressive NHL, the estimated 5-year overall survival rate was higher in patients with normal CA125 levels than in patients with elevated CA125 levels (88% versus 50% and 70% versus 27%, respectively). CONCLUSION: High serum CA125 is an important prognostic factor in NHL and correlates with more advanced disease, low response rates, and worse survival. CA125 measurements may be used for staging, monitoring response to treatment, and follow-up of patients with NHL.     

晚期NSCLC患者血清CEA、NSE、CYFRA211、CA125、CA199检测的临床及预后意义

目的 探讨晚期非小细胞肺癌（NSCLC）患者血清CEA、NSE、CYFRA211、CA125及CA199水平在临床及预后中的意义。方法 化疗前、后检测95例初治晚期NSCLC患者血清CEA、NSE、CYFRA211、CA125及CA199水平。结果 95例患者疗前血清CEA、NSE、CYFRA211、CA125及CA199的阳性率分别为53．7％、70．5％、62．2％、54．1％及31．6％。化疗后部分缓解者的肿瘤标志物水平均明显下降（P值分别为0．030、0．000、0．009、0．002和0．034）。本组患者1年生存率为52．7％（50／95）,2年生存率为14．7％（14／95）,中位生存14个月（部分缓解者17月,稳定者13月,进展者6月）。COX模型多因素分析表明,患者预后与首程化疗疗效、分期、疗前行为状态、CYFRA211有密切关系,与病理分型、疗前CEA、NSE、CA125及CA199无明显关系。结论 CEA、NSE、CYFRA211、CA125及CA199值下降可评价化疗疗效,NSCLC患者的TNM分期、疗前行为状态、疗前CYFRA211及首程化疗疗效有预后意义。     

Serum CA125 level is a good prognostic indicator in lung cancer

The serum CA125 level was determined by a one-step immunoradiometric assay method in patients with lung cancer. Increased serum CA125 levels were observed in 37.8% of patients with squamous cell cancer, in 30.0% of those with adenocarcinoma and in 60.0% of those with small call cancer. Most patients with increased serum CA125 levels were in stages 3 or 4. Patients with pleural effusions or ascites showed high serum CA125 levels. The survival time was significantly shorter in patients with increased serum CA125 levels than in those within normal limits. Among patients with advanced disease (stages 3 and 4), an increased serum CA125 level was again a poor prognostic factor (P less than 0.01). The existence of a pleural effusion did not correlate with the survival time. We conclude that CA125 is a good indicator of disease extent and serum levels correlate to the length of survival.     

CEA、CA125在卵巢癌预后检测和复发诊断中的价值分析

目的 检测卵巢癌患者在不同治疗阶段CEA、CA125含量,探讨其在卵巢癌诊断、预后及早期复发转移的临床价值。方法 采用电化学发光法检测血清中CEA、CA125水平。结果 卵巢癌患者血清中CEA、CA125含量明显高于卵巢癌良性疾病组和正常对照组（P〈0．01）,化疗后CEA、CA125的水平基本下降到正常,复发后又明显升高。结论 检测不同治疗阶段CEA、CA125的含量可作为卵巢癌患者诊断、预后及复发的敏感指标。     

肿瘤标志物CA153、CA125联合检查对乳腺癌诊断的价值分析

目的 探讨联合检查肿瘤标志物CA153、CA125对于乳腺癌诊断的价值.方法 选择123例女性乳腺癌患者作为观察组,选择进行健康体检女性123例作为对照组,对2组进行CA153、CA125联合检查.根据患者乳腺癌分期情况,统计不同分期的患者CA153、CA125单一检查结果和联合检查结果的阳性率、根据患者手术病理检查结果判断联合检查价值,并将观察组与对照组进行对照,探讨肿瘤标志物对于肿瘤检查诊断的敏感性.结果 Ⅰ期乳腺癌患者应用CA153、CA125单一诊断阳性率均明显低于联合诊断阳性率(P＜0.05);Ⅰ期与其他三期患者比较,联合CA153、CA125水平诊断阳性率较低(P＜0.05).观察组患者CA153、CA125联合检测阳性率为88.62%,比照单一检测具有明显差异.CA153水平针对乳腺癌具有更大的检出率.与对照组比较,CA153、CA125水平升高,差距明显(P＜0.05).结论 通过联合检测可以减少乳腺癌患者被误诊几率,避免临床遗漏,但是也不能避免存在假阳性可能;联合检测可以提高单一检测的准确率,临床值得推广.     

Difference in mesothelin‐binding ability of serum CA125 between patients with endometriosis and epithelial ovarian cancer

The epithelial ovarian carcinoma (EOC) is an aggressive malignant tumor, and is currently the leading cause of gynecologic cancer death. CA125 is the most commonly used serum marker for EOC, but shows a high‐false‐positive rate for several benign diseases such as endometriosis. The purpose of our study is therefore to identify a useful biochemical tool for detecting qualitative differences between CA125 from patients with endometriosis and EOC, and to facilitate differential diagnosis of these diseases. In our study, using two different CA125‐binding molecules, i.e., recombinant mesothelin and an anti‐CA125 monoclonal antibody, a novel sandwich ELISA for determining the serum levels of CA125 with mesothelin‐binding ability (CA125^meso) was developed, and tested for patients with endometriosis (n = 59) and EOC (n = 36). We found that both the serum CA125^meso level and the ratio of the serum CA125^meso to CA125 levels (CA125^meso/CA125) were significantly higher in patients with EOC than in patients with endometriosis (p < 0.00005 and p < 0.000001, respectively). Furthermore, receiver operating characteristic analysis showed that the CA125^meso assay was superior to the conventional antibody‐based CA125 assay in discriminating endometriosis from EOC. Thus, mesothelin‐binding ability may be a useful indicator for qualitatively evaluating CA125 in patients with endometriosis and EOC.     

Is an increase in CA 125 in breast cancer patients an indicator of pleural metastases?

The retrospective analysis of 250 breast cancer patients with disseminated disease provided evidence that the increase in CA 125 serum levels in these patients was caused by lung metastases or pleural effusions. Seven patients with lung metastases and pleural involvement had elevated CA 125 levels, while in four patients with lung metastases but without pleural effusions CA 125 levels remained normal. In patients with only bone or liver metastases CA 125 levels were usually not elevated. If these results are confirmed, CA 125 would be the first tumour marker in breast cancer whose levels could be associated with one single site of metastases.