Scientific editor: M. Merkusheva, PSPbGMU them. Acad. Pavlov, general medicine.
March, 2019.
Synonyms: tumor marker of ovarian cancer, carbohydrate antigen, CA 125 tumor marker, Cancer Antigen - 125
CA 125 - a lab value, a marker of cancer pathologies of the female reproductive organs of the ovaries. Analysis for the antigen to diagnose carcinoma start process and predict its course and outcome.
Overview
CA 125 is a chemical compound of the polysaccharide and protein which is an antigen specific types of epithelial cells. Normally, a small concentration of the ingredient is present in the cells of the inner layer of the uterus - the endometrium - and in the body as a part of some biological fluids. Also a slight amount of CA-125 secretes lining the abdominal cavity and pleura, epithelial cells bronchi, pericardium, gall bladder, intestine, pancreas, kidneys, fallopian tubes, testes.
A slight increase in the level of CA 125 can be observed in expectant mothers during the first trimester of pregnancy or in women during menstruation. The pathological growth of blood concentration of the antigen is fixed in malignant, benign and systemic pathologies. For example, nearly 80% of patients with ovarian carcinoma CA-125 values of up to 165 U / ml (at a rate of up to 35 U / ml). In the first and second stages of cancer increase in rate is noted in 50% of cases, but the third and fourth steps are characterized by persistent elevation of tumor marker virtually every woman. Therefore, a test for CA-125 is considered to be quite specific and indicative, but not suitable for early diagnosis because of the low sensitivity of cancer.
The highest value in the CA 125 assay has in determining the dynamics of changes in tumor marker that will help evaluate the effectiveness of the selected treatment regimen and correctly predict remission.
testimony
Most often, the direction of the study of the level of CA-125 gives an oncologist or gynecologist.
Antigen test is recommended to be held in the following cases:
- with suspected ovarian cancer
- assessment of risk of recurrence or metastasis of serous ovarian cancer after therapy;
- monitoring the treatment of endometriosis;
- additional marker in the diagnosis of pancreatic adenocarcinoma, gastrointestinal tract and other organs (bronchi, kidneys, testes, breast, and so on. d.).
In most cases, CA-125 is used to monitor the recurrence of ovarian tumors: raising the level of CA-125 (even in the absence of clinical and radiological findings of relapse) indicates biochemical relapse tumor which leads to clinical 2-6 months.
In clinical studies, CA-125 has proved to be a reliable marker for the monitoring of patients with B-cell non-Hodgkin's lymphoma1.
CA-125 is normal
Important! Rates can vary depending on the reagents and equipment used in a particular laboratory. That is why the interpretation of results it is necessary to use standards adopted in that laboratory, where medical tests. It is also necessary to pay attention to the units.
Women |
men | |
| before menopause | less than 35 U / ml | to 10 IU / ml |
| in menopause | less than 20 U / ml | |
| during pregnancy | to 100 U / ml (rare) |
factors of influence
Distort the result of the study, ie, show a false positive result may be the following reasons:
- intensive drug therapy;
- pregnancy;
- and menstruation cycle disorders;
- chronic stress;
- violation of the rules of delivery of the analysis or blood sampling.
Increase in CA-125
Important! Interpretation of the results is always carried out comprehensively. An accurate diagnosis on the basis of only one analysis impossible.
Increased to 45 U / ml
The slight increase in CA-125 occurs in diseases involving serous membranes:
- pleurisy;
- peritonitis;
- pericarditis.
Increased to 65 U / ml
In the presence of a benign ovarian neoplasms index can normally be increased to 60 U / ml, which is associated with the destruction of the epithelial tissue. In this case, the CA 125 levels should be monitored at regular intervals (for the purpose of risk assessment of malignancy of the tumor), especially for women in menopause.
- benign gynecologic tumors (e.g. myoma);
- inflammatory processes involving the appendages (adnexitis);
- endometriosis.
Increased to 100 U / ml
Increasing CA-125 to 100 U / ml or higher indicates a risk of developing a malignant process and the need for additional studies, including tests for tumor markers HE4.
- Ovarian carcinoma;
- cervical adenocarcinoma;
- Endometrial cancer;
- Cancer other internal organs, including the representatives of the male3.
CA 125 level may be correlated with index natriuretic hormone, so the test results determine the severity of heart failure.
Preparation for analysis
The biomaterial for research: venous blood.
method of collecting biological material: venipuncture cubital vein.
Mandatory requirements: blood sampling is performed in the morning (from 8.00 to 11.00) is strictly on an empty stomach (during an overnight fast of at least 10 hours).
Additional conditions:
- 1-2 weeks to stop taking drugs or to discuss the possibility of their use with your doctor before analysis, indicating the dosage, treatment scheme, name and so on. etc .;
- the day before the test to eliminate the emotional and physical stress;
- eve does not take alcohol and tonics;
- dinner do not eat fat, smoked, fried foods, semi-finished products;
- the day of the procedure does not chew tobacco or smoke;
- for 3 hours before analysis can drink only water without a conventional gas;
Important! The form of analysis should be specified definitely, what day of the cycle is carried out the study, as in avoid unreliable results on blood CA 125 is recommended to take 2-3 days after menses.
sources:
- 1. Memar B. Aledavood A. The Prognostic Role of Tumor Marker CA-125 in B-Cell non-Hodgkin's Lymphoma. - MEDLINE® / PubMed®, a database of the U.S. National Library of Medicine, 2015.
- 2. A.A.Kishkun, prof. Manual for the laboratory diagnosis methods - GEOTAR-Media, 2007.
- 3. Gentry George T King, MD. CA 125. - Medscape, 2015.
