ABSTRACT
Cancer antigen [CA] 125 is the only known glycoprotein marker increased by active synthesis by peritoneal epithelium in the presence of ascites alone. The aim of this work is the evaluation of diagnostic and prognostic significance of serum CA125 in cases with spontaneous bacterial peritonitis [SBP]. Two groups of patients were examined for serum level of CA125. Group I: 20 patients with cirrhotic ascites and SBP, diagnosed by ascitic PMN count >/= 250/mm[3] and positive ascitic fluid culture. Group ll: 24 patients with sterile cirrhotic ascites. Other causes of CA 125 elevation [mainly malignancies and gynecological diseases] were excluded. All cases with SBP were treated and the serum CA 125 level was re-tested in the 10 patients who completed therapy. Significantly elevated levels of serum CA125 were found in patients with SBP [group I] which were more than that found in group II [338.8 +/- 89.9 vs. 149.3 +/- 58.6, p<0.001]. This increase of CA125 in SBP cases was not related to amount of ascites, type of causative bacteria, cause of cirrhosis, liver and kidney function tests, or ascitic PMN count. Therapy of SBP led to significant decrease of CA 125 in survivors [1 55 +/- 37.85vs. 309.5 +/- 42.4, p< 0.001]. The sensitivity, specificity and diagnostic accuracy of serum CA 125 in diagnosis of SBP [when the cut- off level was 240/Uml] were 100%, 83.3% and 90.9% respectively, although it had no prognostic value. In conclusion serum CA 125 can be used as easy and rapid screening test to diagnose of SBP