Do serum CA 19-9 and CA 125 levels predict the severity of HCV-related liver fibrosis?

ABSTRACT

To study the value of measurement of serum tumor markers CA 19-9 and CA 125 as predictors of severity of liver fibrosis in patients with chronic hepatitis C. Fifty patients with chronic hepatitis C were recruited from the Hepatology and Gastroenterology Department at Ain Shams University Hospital. They were 31 men and 19 women, with ages ranging from 18 to 50 years. Participants were subjected to full clinical examination, liver function tests, viral markers [hepatitis B surface antigen, hepatitis C virus antibody], a fetoprotein, autoimmune markers, assay of serum levels of CA 19-9 and CA 125, abdominal ultrasonography, and ultrasound-guided liver biopsy. Histopathological examination for staging of liver fibrosis was performed using the Ishak scoring system. There was a highly significant positive correlation between serum levels of CA 19-9 and CA 125 and the stage of liver fibrosis [P<0.01]. There was also a difference in the mean values of serum CA 19-9 among different stages of liver fibrosis. Similar differences were seen for CA 125. The best cut-off value for CA 19-9 in predicting severe liver fibrosis and cirrhosis [stages 5, 6] was found to be 33.87 U/ml with sensitivity of 93.8% and specificity of 88.2%, whereas the best cut-off value for CA 125 in predicting severe liver fibrosis and cirrhosis [stages 5, 6] was found to be 25 U/ml with sensitivity of 93.8% and specificity of 82.4%. Combined elevation of CA 19-9 and CA 125 above the cut-off value showed less sensitivity [87.5%] than that of each of CA 19-9 [93.8%] and CA 125 [93.8%], and a better specificity [88.24%] than that of CA 19-9 [88.2%] and CA 125 [82.4%]. Serum CA 19-9 and CA 125 may be used as noninvasive markers of severe hepatitis C virus-related liver fibrosis. This needs to be validated by more studies