Struma ovarii-associated pseudo-Meigs−syndrome with concomitant abdominopelvic tuberculosis masquerading as ovarian malignancy / Philippine Journal of Obstetrics and Gynecology

@#Pseudo-Meigs' syndrome (PMS) is a rare disease characterized by the triad of (1) an ovarian neoplasm, other than a fibroma or thecoma, (2) ascites, and (3) pleural effusion. Tumors such as struma ovarii, mucinous and serous cystadenomas, and germ cell tumors have been linked with the condition. Due to its clinical features combined with the elevation of serum cancer antigen 125 (CA-125) levels, it is often mistaken and treated as a malignant ovarian tumor. Ascites or pleural effusion could be massive leading to various life-threatening complications. Despite its presentation, this entity has an excellent prognosis when surgical excision of the tumor is performed. This article presents an unusual case of a 41-year-old gravida 10 para 10 (10-0-0-9) who was diagnosed with a case of struma ovarii associated PMS with concomitant abdominopelvic tuberculosis and elevated CA-125 resembling an ovarian malignancy.

Tissue trauma and inflammatory response following laparoscopic versus abdominal hysterectomy: a prospective randomized clinical trial

Background: Laparoscopic surgery is associated with more favorable clinical outcome than conventional open surgery. This might be related to the magnitude of tissue trauma and tissue stress response. This study compares the intensity of tissue injury by assessing plasma C-reactive protein (CRP), lactic dehydrogenase (LDH), and cancer antigen 125 (CA 125) in patients undergoing laparoscopic hysterectomy compared to abdominal hysterectomy.Methods: This study was conducted at Ain Shams University Maternity Hospital from May 2018 to February 2020. 74 women candidate for hysterectomy were recruited and randomized into two groups: group A included 37 cases who underwent abdominal hysterectomy, and group B included 37 cases that underwent laparoscopic hysterectomy.Results: CRP, LDH and CA125 significantly increased post-operatively in both groups. Postoperative mean serum CRP, LDH and CA125 were significantly higher in the laparotomy group (10.84±2.47, 262.21±76.77, and 13.41±2.6 respectively) compared to laparoscopy group (7.92±2.25, 148.53±43.56, 11.79±2.77 respectively) (p<0.05).Conclusions: Surgery is a significant cause of tissue injury that can be assessed by specific markers. We suggest that laparoscopic surgery causes less tissue damage as assessed by lower postoperative CRP and LDH values, which might account for the earlier recovery and reduced hospital stay in laparoscopic surgery.

Role of cancer antigen-125 in diagnosing malignant adnexal masses: a prospective observational study

Background: Adnexal masses present a diagnostic and therapeutic dilemma across age-groups. This study aimed to evaluate the performance of cancer antigen-125 (CA-125) in distinguishing between benign and malignant adnexal masses.Methods: This was a prospective, observational, single tertiary-care center study, done in North India from January, 2011 till December, 2012. Serum CA-125 levels was obtained preoperatively in consecutive patients presenting with ultrasonography confirmed adnexal masses. The cut-off value between benign and malignant was taken as 35 IU/ml. Histopathological diagnosis was obtained in all patients.Results: A total of 126 patients presented with adnexal masses, of which 100 were enrolled (mean age: 37.5±14.4 years, range: 18-80 years). Most of the masses were benign 81% (malignant=19%). Dermoid cyst (25.9%) and endometriomas (21%) were the most common benign masses. Serous (21%) and mucinous cystadeno-carcinoma (15.8%) were the most common malignant masses, more often seen in elderly, married, parous and post-menopausal patients. Mean CA-125 levels were significantly higher in malignant masses (257.30 [105.68-408.92] versus 19.26 [16.53-22.00], p<0.001). Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CA-125 for diagnosing malignant adnexal mass was 94.7%, 87.65%, 64.28%, 98.6%, and 88.91% respectively. The same was 100%, 85.1%, 54.5%, 100%, 87.3% in premenopausal and 85.7%, 100%, 100%, 93.3%, 95.2% in postmenopausal women respectively.Conclusion: Benign masses form the bulk of the adnexal masses in all age groups. CA-125 levels has high sensitivity and negative predictive value in premenopausal patients while as high specificity and positive predictive value in postmenopausal patients.

Clinical Usefulness of Cancer Antigen (CA) 125, Human Epididymis 4, and CA72-4 Levels and Risk of Ovarian Malignancy Algorithm Values for Diagnosing Ovarian Tumors in Korean Patients With and Without Endometriosis

BACKGROUND: Tumor markers are useful for detection and preoperative evaluation of ovarian tumors. We evaluated the clinical usefulness of cancer antigen (CA) 125, human epididymis 4 (HE4), and CA72-4 levels and Risk of Ovarian Malignancy Algorithm (ROMA) values for differential diagnosis of malignant and borderline tumors among suspected ovarian tumors, and the effects of endometriosis on these tumor markers. METHODS: In a total of 266 patients (213, 14, and 39 with benign, borderline and malignant tumors, respectively), CA125, HE4, and CA72-4 levels were measured, and ROMA values were calculated. Medians of each marker were compared among the three groups. The area under the ROC curve (AUC), sensitivity, and specificity were calculated to analyze the diagnostic performance of each marker. RESULTS: All markers were significantly higher in the malignant group than in the benign group. HE4 levels and ROMA values were significantly higher in the malignant group than in the borderline group. ROMA value had the highest AUC for distinguishing the malignant and borderline groups from the benign group in premenopausal (0.773) and postmenopausal (0.927) patients. CA125 level was significantly higher in patients with endometriosis than in those without (P<0.001), whereas HE4 and CA72-4 levels were not affected by endometriosis (P=0.128 and 0.271, respectively). CONCLUSIONS: ROMA value is the best marker to distinguish malignant and borderline tumors from benign tumors in pre- and postmenopausal patients. HE4 and CA72-4 levels provide information on possible CA125 elevation due to endometriosis.

Comparison of serum cancer antigen 125, human epididymis protein 4, ROMA, and CPH-I for diagnosis of ovarian cancer in Chinese patients with ovarian mass / 南方医科大学学报

OBJECTIVE@#To compare the performance of serum cancer antigen 125 (CA125), human epididymis protein 4 (HE4), Risk of Ovarian Malignancy Algorithm (ROMA) and Copenhagen index (CPH-I) for differential diagnosis of benign and malignant diseases in patients with ovarian mass.@*METHODS@#We retrospectively analyzed the data of 719 women with pelvic mass, and the performance of preoperative serum levels of CA125 and HE4, ROMA and CPH-I for differential diagnosis of the masses was compared.@*RESULTS@#Of the 710 women analyzed, 531 were diagnosed with benign ovarian lesions, 44 with borderline ovarian tumors (BOTs), 119 with epithelial ovarian cancers (EOCs), and 25 with non-EOCs. In differentiating ovarian cancer (OC) and BOT from benign lesions, the area under the receiver-operator characteristic (ROC) curve (AUC) was 0.854 for HE4, 0.856 for ROMA, 0.854 for CPH-I, and 0.792 for CA125, demonstrating better diagnostic performance of HE4, ROMA, and CPH-I than CA125 alone; the diagnostic sensitivity was 56.9% for HE4, 70.2% for CA125, 69.1% for ROMA, and 63.8% for CPH-I; the specificity was the best with HE4 (94.4%) and CPH-I (94.7%). In sub-analysis of EOC benign lesions, the AUCs of HE4, ROMA, and CPH-I increased to 0.946, 0.947, and 0.943, respectively, all greater than that of CA125 (0.888). In other sub-analyses, HE4, ROMA, and CPH-I all showed greater AUCs than CA125 alone.@*CONCLUSIONS@#This study confirms the accuracy of HE4, ROMA, and CPH-I for differentiating malignant from benign ovarian mass, and all these 3 tests show better performance than CA125. Furthermore, HE4 and CPH-I is superior to ROMA and CA125 in terms of specificity, while CA125 and ROMA have better diagnostic sensitivities.

Diagnostic value of copeptin and cancer antigen 125 in acute heart failure patients with atrial fibrillation and their correlations with short-term cardiovascular events / 中华危重病急救医学

Objective To evaluate the diagnostic value of copeptin and cancer antigen 125 (Ca-125) in acute heart failure (AHF) patients with atrial fibrillation, and to explore the relationship between copeptin, Ca-125 and short-term cardiovascular events. Methods A total of 376 patients with acute left heart failure or permanent atrial fibrillation admitted to the Department of Cardiology of First Affiliated Hospital of Nanjing Medical University from January 2016 to January 2018 were enrolled as the study group. According to whether having atrial fibrillation or not, 376 patients were divided into atrial fibrillation group (n = 108), AHF group (n = 134) and AHF with atrial fibrillation group (n = 134). 102 healthy persons in the same period were enrolled as healthy control group. Copeptin, Ca-125, N-terminal pro-brain natriuretic peptide (NT-proBNP) within 24 hours after admission or on the day of physical examination were determined, and cardiac function indexes including left atrial diameter (LAD), left ventricular diameter (LVD) and left ventricular ejection fraction (LVEF) at 1 week after admission or on the day of physical examination were determined. Correlation analysis among above indexes was conducted by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of copeptin and Ca-125 in AHF with atrial fibrillation. Results Compared with the healthy control group, copeptin, Ca-125, NT-proBNP, LAD, and LVD in atrial fibrillation group, AHF group and AHF with atrial fibrillation group showed a tendency of gradual increase [copeptin (pmol/L): 12.43±4.36, 18.77±5.29, 32.82±7.07 vs. 6.68±1.94; Ca-125 (kU/L): 18.82±7.39, 27.97±11.47, 61.37±25.49 vs. 4.43±1.74; NT-proBNP (ng/L): 1 070.87±428.84, 1 734.13±725.09, 2 745.92±709.91 vs. 570.40±213.87; LAD (mm): 37.24±6.35, 41.31±7.94, 46.24±10.96 vs. 33.29±4.53; LVD (mm): 49.46±5.19, 52.51±8.09, 55.96±6.49 vs. 45.99±6.26, all P < 0.05], and LVEF showed a tendency of gradual decrease (0.52±0.11, 0.46±0.10, 0.41±0.09 vs. 0.57±0.08, all P < 0.05), indicating that the deterioration of all indexes in AHF patients with atrial fibrillation was more obvious. Correlation analysis showed that copeptin was positively correlated with LAD (r = 0.479, P = 0.012) and LVD (r = 0.513, P = 0.005), and it was negatively correlated with LVEF (r = -0.626, P < 0.001). Ca-125 was positively correlated with LAD (r = 0.479, P = 0.011) and LVD (r = 0.513, P = 0.028), and it was negatively correlated with LVEF (r = -0.645, P = 0.019). ROC curve analysis showed that the area under ROC curve (AUC) of copeptin, Ca-125, NT-proBNP and copeptin combined with Ca-125 in the diagnosis of AHF with atrial fibrillation was 0.750, 0.623, 0.647 and 0.842, respectively, with diagnostic value on AHF with atrial fibrillation. The diagnostic value of copeptin combined with Ca-125 was the largest, with a sensitivity of 72.64% and a specificity of 92.47%. Compared with the healthy control group, the incidence of cardiovascular events after 3 months of follow-up in the atrial fibrillation group, AHF group and AHF with atrial fibrillation group was significantly increased [6.5% (7/108), 9.0% (12/134), 30.6% (41/134) vs. 1.0% (1/102), χ2 = 56.574, P = 0.000], indicating that patients with AHF and atrial fibrillation were more likely to have cardiovascular events. Copeptin combined with Ca-125 showed a significant positive correlation with short-term cardiovascular events (r = 0.641, P = 0.004). Conclusions The combination of copeptin and Ca-125 has a higher diagnostic accuracy for AHF patients with atrial fibrillation. Copeptin and Ca-125 were positively correlated with short-term cardiovascular events. It may be used to assess the prognosis of AHF patients with atrial fibrillation.

Levels of Serum CA125, hs-CRP, and TNF-α in Patients with Chronic Heart Failure, and the Association with Cardiac Function / 中国医科大学学报

Objective To detect changes in serum cancer antigen 125 (CA125),tumor necrosis factor-alpha (TNF-α),and high-sensitivity C-reactive protein (hs-CRP) in patients with chronic heart failure (CHF),before and after treatment,and to examine the relationship between CA125 and cardiac function.Methods From June 2015 to December 2016,84 patients with CHF in our hospital were selected as the observation group and 72 healthy persons were selected as the control group.Fasting venous blood CA125,TNF-α,and hs-CRP levels were measured before and after treatment.The cardiac left ventricular ejection fraction (LVEF) was measured in both groups using echocardiography.Results The levels of CA125,TNF-α,and hs-CRP in the contml group were significantly lower than those in the observation group.The LVEF in the control group was significantly higher than in the observation group (P ＜ 0.05).After heart failure treatment,the levels of CA125,TNF-α,and hs-CRP significantly decreased in the observation group,and LVEF showed marked improvement (P ＜ 0.05).Analysis showed that the serum CA 125 level in patients with CHF was positively correlated with TNF-α and hs-CRP levels,and was negatively correlated with LVEF.Conclusion The levels of CA125,TNF-α,and hs-CRP in patients with CHF could have potential for the evaluation of CHF status and treatment results.

The value of HE4, CA125, and ROMA model in diagnosis of the ovarian carcinoma / 重庆医学

Objective To explore the value of human epididymis protein 4(HE4),cancer antigen 125(CA125) and the risk of ovarian malignancy algorithm(ROMA) in the diagnosis of ovarian cancer.Methods Electrochemical luminescence and Enzymelinked immunosorbent assay (ELISA) were used to determine the levels of serum HE4,CA125 in 56 patients with ovarian carcinoma,73 cases of ovarian benign tumor and 50 health women,and the ROMA was calculated by HE4 and CA125 levels depending on the menopause state,drawing the receiver operating characteristics(ROC) curve and calculating the area under the curve(AUC).Results The average levels of the HE4,CA125 and the value of the ROMA were (345.33±605.03)pmol/L,(701.46±1 500.30) U/mL,(58.72±31.00) ％ in the ovarian carcinoma group,(53.84± 14.68)pmol/L,(44.25±45.81)U/mL,(10.80± 6.75) ％ in the ovarian benign tumor group,and (46.03±10.26)pmol/L,(17.39±10.64)U/mL,(6.92±3.85)％ in the health control group respectively,compared with the benign tumor group and the health control group,the ovarian carcinoma group were higher in HE4,CA125 and the ROMA value,and the difference were significantly (P＜0.05),whereas compared in the ovarian benign group and the health group,except the CA125 was higher in the benign group and the difference had statistical significance(P＜0.05),the HE4 level and the value of the ROMA had no statistical significance(P＞0.05).The sensitivities of the HE4,CA125 and ROMA were 71.43％,76.79 ％,89.28％,the specificities were 93.15 ％,53.42％,94.52 ％ and the ROC-AUCs were 0.930,0.809,0.937 respectively.When the specificity for the diagnosis of the ovarian carcinoma was 95.00％,the sensitivities of the HE4,CA125 and ROMA were 80.40％,53.60％,83.90％ respectively.Conclusion HE4 and CA125 combined detection to calculate the ROMA can elevate the sensitivity and specificity for the ovarian carcinoma diagnosis.

Clinical application of combined detection of HE4 and CA125 in patients with endometriosis / 国际检验医学杂志

Objective To investigate the application value of single or combined detection of HE4 and CA125 in the differentia‐tion diagnosis of endometriosis .Methods The detection results of serum HE4 and CA125 levels in 105 cases of patients with ovari‐an endometriosis (endometriosis group) ,53 cases of patients with (ovarian malignant group) tumor and 64 healthy women undergo‐ing the healthy physical examination(control group) were performed the retrospective and statistical analysis .Results The positive rates of serum HE4 in the endometriosis group ,ovarian malignant tumor group and control group were 57 .1% ,90 .6% and 12 .5%respectively with statistically significant difference among them (P< 0 .05) .The positive rates of serum CA125 in the above 3 groups were 44 .8% ,92 .5% and 14 .0% respectively ,and the differences were statistically significant(P<0 .05) .(3)The sensitivity and specificity of 70 pmol/L≤ HE4<150 pmol/L for diagnosing endometriosis were 57 .14% and 53 .86% respectively ,which of 35 U/mL≤CA125<150 U/mL for diagnosing endometriosis were 44 .76% and 61 .24% .But the sensitivity and specificity of their combined detection were 70 .32% and 60 .38% .There were statistically significant differences of sensitivity and specificity among single and combined detecion of HE4 and CA125(P<0 .05) .Conclusion Serum HE4 and CA125 levels are significantly elevated in the patients with endometriosis ,their combined detection could further raise the sensitivity for diagnosing endometriosis .

Post-treatment alterations of serum cancer antigen 125, cancer antigen 19.9 and carcinoembryonic antigen levels in patients with gynecological malignancies in a tertiary care hospital in eastern India.

Gynecological carcinomas form a significant proportion of all malignancies in women across the globe. These are associated with an increase in the serum concentrations of certain tumor markers such as cancer antigen (CA)125, CA19.9 and carcinoembryonic antigen (CEA) that correlate with the tumor burden. Methods: Pre- and post-treatment serum levels of CA125, CA19.9 and CEA were determined in 36 patients of ovarian carcinoma, 31 patients of cervical carcinoma and 20 patients of endometrial carcinoma using enzyme-linked immunosorbent assay. The pre- and the post-treatment levels of these markers have been compared and correlated. Results: With primary treatment, CA125 level was significantly reduced in ovarian, endometrial (ps < 0.001) and cervical (p = 0.001) carcinomas and that of CA19.9 was significantly decreased in cervical and endometrial carcinomas (ps < 0.001). Surprisingly, post-treatment CEA level was significantly increased in cervical carcinoma (p = 0.001) with significant increase after radiotherapy (p = 0.003), but not after surgery (p = 0.091). Treatment had no effects on CA19.9 level in ovarian carcinoma and on CEA levels in ovarian and endometrial carcinomas. Pre- and post-treatment levels of CA125, CA19.9 and CEA showed strong positive correlation in cervical carcinoma, while those of CA19.9 showed very strong positive correlation in endometrial carcinoma. Conclusions: Post-treatment serum CA125 level best reflects the treatment effect in all three types of gynecological carcinomas. CA19.9 is reliable to evaluate treatment effect in patients of cervical and endometrial carcinomas. Studies involving larger population size should be conducted to identify the changes in CEA while assessing treatment effect in cervical carcinoma patients.

The expression and significance of serum CA-125 in patients with Budd-Chiari Syndrome / 中华肝胆外科杂志

Objective To investigated the serum level of carcinoma antigen 125 (CA-125) and its clinical significance in patients with Budd-Chiari syndrome.Methods We reviewed medical records and laboratory tests of patients with BCS first diagnosed in our hospital between August 2011 and April 2013.235 patients were included as experiment group,while 120 healthy adult volunteers were randomly selected as control group.The serum level of CA-125 were detected by electrochemilumescence immunization assay in this single-center retrospective control study.Results The average serum level of CA-125 in experiment group is higher than that of control group [(147.9 ±246.6) kU/L vs (16.0 ±7.2) kU/L,P ＜0.001].In experiment group,the relative coefficient for serum CA-125 with ascites,alanine aminotransferase,aspartate aminotransferase,albumin and Rotterdam BCS scores was 0.79,0.45,0.29,-0.393 and 0.71,respec tively,P ＜0.001.As of October 2013,we found that the 68 BCS patients with serum CA-125 level 5-fold higher than the upper limit of normal (＞ 175 kU/L) presented much lower survival rates and asymptomatic survival rates than the rest 167 BCS patients after intervention therapy:(95.6％ and 79.8％) vs (98.8％ and 92.0％),P ＜ 0.05.Conclusions The serum level of CA-125 in BCS patients have positive correlation with ascites volume,liver injury degree and Rotterdam BCS scores.Serum CA-125 evaluation appears to be a valuable examination option in BCS as CA-125 levels negatively correlate with worse prognosis,thus could be applied as an efficient tool for prognostication.

Effects of glucocorticoid in patients with tuberculous pleuritis and its impact on the level of serum cancer antigen 125 / 中国医师进修杂志

Objective To investigate the effects of glucocorticoid in patients with tuberculous pleuritis and its impact on the level of serum cancer antigen 125 to provide theoretical basis for the treatment of tuberculous pleuritis.Methods One hundred and sixty patients with tuberculous pleuritis were divided into treatment group and control group with 80 cases each by random digits table method.The patients in two groups were given anti-TB medication,and the treatment group was given oral prednisone on the basis of anti-TB medication.The clinical efficacy and serum cancer antigen 125 level change was observed.Results Thirty-seven cases had excellent effect,35 cases showed good effect,and 8 cases was invalid in treatment group and there were 16,45 and 19 cases in control group respectively,and there was significant difference between two groups(P ＜ 0.05).The fever subsidence time,pleural effusion subsidence time,pleural effusion drawing volume,and thickening of pleura in treatment group was less than that in control group [(9.16 ±3.74) d vs.(15.54 ± 0.97) d,(11.78 ± 3.86) d vs.(16.78 ± 3.50) d,(2345.64 ± 321.75) ml vs.(3549.03 ±434.86) ml,40.00％(32/80) vs.80.00％(64/80)],and there was significant difference (P ＜ 0.05).There was no significant difference in serum cancer antigen 125 before treatment between two groups (P ＞ 0.05).The levels of serum cancer antigen 125 after treatment of 7,14 and 30 d in treatment group was lower than that in control group [(268.78 ± 93.86) μ g/L vs.(385.78 ± 143.43) μ g/L,(159.64 ± 31.96) μg/L vs.(255.03 ± 44.56) μg/L,(45.34 ± 12.94) μg/L vs.(167.75 ± 32.76) μ g/L],and there was significant difference (P ＜ 0.05).Conclusions The clinical efficacy of glucocorticoid in treatment of tuberculous pleuritis can improve the clinical symptoms early.It is worthy of clinical application.

The clinical value of serum CA125 in diagnosis of endometriosis caused pelvic pain / 中国基层医药

Objective To study the correlation of serum CA125 level and differentiation of endometriosis (EMs) and pelvic pain due to Ems.Methods The clincal data of 305 EMs patients were retrospectively analyzed,and they were divided into I,Ⅱ,Ⅲ,Ⅳ four stage according to r-AFS.The relevance of preoperative serum CA125 and differentiation of Ems and pelvic pain were assessed and statistically analyzed.Results The serum CA125 level was higher in Ⅲ,Ⅳ stage (69.4 ± 5.7) U/ml,(171 ± 11.5) U/ml than that in Ⅰ,Ⅱ stage (14.8 ± 1.2) U/ml,(36.3 ±3.0) U/ml,there was statistically significant difference (P ＜ 0.05).The positive rate of CA125 increased progressively (12.1％,21.5％,40.2％,63.9％),but the difference was not statistically significant(P ＞ 0.05).The pain syndromes in the clinical features of differentiation of Ems had obvious difference (P ＜ 0.05).Conclusion The serum CA125 detecting can be used in differentiation of Ems,and it has important value in diagnosis and prognosis of EMs.

Clinical significance of serum cancer antigen 125 in patients with pleural effusions / 中国综合临床

Objective To investigate the change of serum cancer antigen(CA) 125 in patients with pleural effusion.Methods One hundred and twenty-eight patients with pleural effusion were admitted to the Naval General Hospital of People's Liberation Army from January 2010 to September 2012 were selected as our subjects.The level of serum CA125 was measured.The difference of serum CA125 positive rate and level were compared according to gender,pleural effusion nature,quantity and pleural effusion chest area; And the difference of patients with malignant pleural effusion tuberculosis,inflammatory,exudative pleural effusion based on above indicators.The correlation between serum CA125 level and pleural effusion depth were analyzed.Results The positive proportions of CA125 were 83.3％ (35/42) and 76.7 ％ (66/88) of patients with malignant and benign effusion respectively,and there was no significant difference (x2 =0.74,P ＞ 0.05).The serum CA125 level of patients with malignant pleural effusion was significantly higher than benign ones ((177.8 ± 31.4) U/ml vs.(110.6 ± 13.6) U/ml,t =31.24,P ＜ 0.05).There were no significant difference in the positive proportion of serum CA125 between malignant,tuberculous,inflammatory and transudative pleural effusion(75.8％ (25/33),70.0％ (20/29),87.5％ (21/24) and 83.3％ (35/42),P ＞ 0.05).Serum CA125 levels of patients with malignant pleural effusion were significantly higher than that with inflammatory ((177.8 ± 31.4) U/ml vs.(72.5 ± 12.8) U/ml,P ＜ 0.05),but the differences were not significant among malignant,tuberculous and transudative pleural effusion group((140.6 ± 28.2) U/ml,(154.3 ± 30.5) U/ml,P ＞ 0.05).The serum CA125 levels of patients with small,moderate and large effusions were (56.4 ± 18.2) U/ml,(120.2 ± 24.5) U/ml and (185.5 ± 34.6) U/ml respectively,and the difference among these groups were significant(F =296.03,P ＜ 0.05).Serum CA125 levels was positively correlated with pleural fluid depth (r =0.56,P ＜0.01).Different gender,pleural effusion parts serum CA125 positive rate and the different levels were not statistically significant (P ＞ 0.05).Conclusion Serum CA125 increased in patients with benign and malignant pleural effusion,and serum CA125 was not severed as the diagnosis biomarker in differentiating benign and malignant pleural effusion.Serum CA125 levels is helpful in monitoring the change of pleural fluid size due to the relation with depth of pleural fluid.

The diagnostic value of combined detection of tumor markers for malignant pleural effusions / 中国综合临床

Objective To investigate the significance of combined detection of tumor markers in serum and pleural fluid on differential diagnosis of benign and malignant pleural effusion.Methods Three hundred and seventy six cases of pleural effusion were selected.The levels of carcinoembryonic antigen (CEA),neuronspecific enolase(NSE),cancer antigen 125 ( CA125 ),squamous cell carcinoma antigen (SCC) in serum and pleural fluid were examined and they were analyzed combined with histological or cytological evidence using statistical methods.Results There were 298 cases in malignant group and 98 cases in benign group.The levels of the four tumor markers in malignant group were significantly higher than in benign group both in pleural fluid (CEA:[279.9 ± 170.0]μg/L v.s.[ 12.6 ± 6.2 ] μg/L,t =6.29,P ＜ 0.01; NSE:[ 112.3 ± 86.8 ] μg/L v.s.[14.7 ±7.3] μg/L,t =5.13,P ＜0.01 ;SCC:[ 10.6 ± 5.4] μg/L v.s.[ 1.2 ±0.6 ] μg/L,t =2.34,P ＜0.01;CA125:[ 409.2 ± 206.7] U/ml v.s.[ 44.0 ± 20.5 ] U/ml,t =7.46,P ＜ 0.01 ) and in serum ( CEA:[ 86.7 ±42.0] μg/L v.s.[6.2±3.1]μg/L,t=3.14,P＜0.01;NSE:[31.6±18.2]μg/Lv.s.[11.2±5.0]μg/L,t=4.61,P＜0.01;SCC:[3.5±2.2]μg/Lv.s.[1.8±0.g]μg/L,t=1.70,P＜0.01;CA125:[134.0±72.6]U/ml v.s.[ 19.8 ± 9.6 ] U/m1,t =4.04,P ＜ 0.01 ).Moreover,the levels of tumor markers in pleural fluid were higher than in serum.The sensitivity were 100％ by combined detection of pleural fluid and serum tumor markers in parallel and the specificity were 100％ in sequence.Conclusion The levels of CEA,NSE,CA125,SCC in pleural effusion were more sensjtive than which in serum.Combined detection of tumor markers in pleural fluid and serum could improve the sensitivity of diagnosis for benign and malignant pleural effusion.

Changes in serum and dialysate levels of Cancer Antigen 125 (CA125) in continuous ambulatory peritoneal dialysis patients / 대한내과학회지

BACKGROUND: Peritoneal mesothelial cells are the most important intraperitoneal cells quantitatively and have the capability to secret different types of substances. It may therefore be essential to have information on the mesothelial cell mass during peritoneal dialysis. Cancer Antigen 125 (CA125) is a 22KDa glycoprotein which is a clinically useful tumor marker of non-mucinous epithelial ovarian carcinoma. Recently, other cells including pleural and peritoneal mesothelial cell have been proved to express CA125. This study was undertaken to determine whether CA125 can be used as a marker of mesothelial cell mass in clinically stable 39 CAPD patients. METHODS: We checked serum and peritoneal dialysate CA125 level, D/P creatinine and D/Do glucose after 4 hours dwell in 39 stable continuous ambulatory CAPD patients. RESULTS: No statistically significant correlation was seen among the patient's age, sex, serum and dialysate levels of CA125. The dialysate CA125 levels correlated with the duration of CAPD, negatively (r=-0.345, p=0.039) and a significant positive correlation was seen between the duration of CAPD and D/Do glucose at 4 hours (r=0.523, p=0.001). But there were not a correlation between the dialysate CA125 levels and D/P creatinine after 4 hours dwell nor between the dialysate CA125 levels and D/Do glucose after 4 hours dwell. CONCLUSION: Although the duration of CAPD affects CA125 levels in dialysate, no specific alteration in peritoneal membrance transport properties can be detected or predicted by changes in dialysate concentration of CA125. However longitudinal follow-up of changes in concentration of dialysate CA125 may be useful in evaluating mesothelial cell mass in stable CAPD patients.Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.