Influence of exogenous estrogen administration on serum CA‐125 originating from the endometrium

Karabacak, Recep Onur; Ilgin, Neşe; Tıraş, Bülent; Gursoy, R.; Himmetoğlu, Özdemir

doi:10.1016/s0020-7292(01)00524-0

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…However, for women with a uterus, Karabacak reported that 100 ug/day transdermal estradiol was associated with a significant increase in CA-125, again consistent with our results. [25] In contrast, Cengiz et al reported that current use of combination of estrogen and progestin resulted in lower CA-125 levels in women with a uterus, while Okon et al saw no change in their 12 month follow-up study. [26;27] The type of hormone therapy used was not determined in our study, but it is likely that estrogen-only therapy would predominate in the women with hysterectomy and estrogen-progestogen therapy would predominate in women with a uterus.…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of CA-125 in women without evidence of ovarian cancer in the Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) Screening Trial

Johnson

Kessel

Riley³

et al. 2008

Gynecologic Oncology

100

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Objective-To determine the epidemiology of CA-125 in women without ovarian cancer.Methods-We analyzed demographic, medical and lifestyle characteristics related to CA-125, measured using the Centocor CA-125II RIA assay, among 25,608 multi-ethnic U.S. women aged 55-74 years enrolled in a cancer screening trial and found to have no evidence of ovarian cancer.Results-Mean CA-125 level was 11.9 U/ml (SD 8.3); median 10.0 U/ml, interquartile range 8.0-14.0. High levels, using the clinical cut point of ≥ 35 U/ml, were associated with increased age (p<0.001) and former smoking (p<0.021), while hysterectomy and obesity were protective (p<0.001). Mean levels were higher with increasing age (p<0.001), ever use of hormone therapy (p<0.001), former smoking (p<0.017) and history of breast cancer (p<0.002), but lower (p<0.001) with non-White status, previous hysterectomy, current smoking, and obesity. Current hormone therapy use was not associated with CA-125 in women without a uterus.Conclusion-In post-menopausal women without ovarian cancer, CA-125 level is influenced by a number of factors, including race/ethnicity, age, hysterectomy, smoking history and obesity.

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Section: Discussionmentioning

confidence: 99%

The epidemiology of CA-125 in women without evidence of ovarian cancer in the Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) Screening Trial

Johnson

Kessel

Riley³

et al. 2008

Gynecologic Oncology

100

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“…Use of estrogen-alone HT was associated with lower CA125 concentrations; these associations persisted in multivariable models but were only evident among women with hysterectomy in stratified models. Administered transdermal 17ß-estradiol has previously been associated with an increase in circulating CA125 in women without hysterectomy [29] and HT use (overall; formulation not specified) was associated with higher CA125 in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) [6]. However, a positive association between HT and CA125 has not been universally observed [23, 30].…”

Section: Discussionmentioning

confidence: 99%

“…Smoking may reduce CA125 concentrations via its effect on endogenous estrogens. Smoking is inversely associated with endogenous estrogens [44], whereas administered estradiol is associated with higher circulating CA125 [29]. Further, smoking is associated with earlier age at menopause [45], which, in turn, is associated with lower CA125.…”

Section: Discussionmentioning

confidence: 99%

Correlates of circulating ovarian cancer early detection markers and their contribution to discrimination of early detection models: results from the EPIC cohort

et al. 2017

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BackgroundOvarian cancer early detection markers CA125, CA15.3, HE4, and CA72.4 vary between healthy women, limiting their utility for screening.MethodsWe evaluated cross-sectional relationships between lifestyle and reproductive factors and these markers among controls (n = 1910) from a nested case-control study in the European Prospective Investigation into Cancer and Nutrition (EPIC). Improvements in discrimination of prediction models adjusting for correlates of the markers were evaluated among postmenopausal women in the nested case-control study (n = 590 cases). Generalized linear models were used to calculate geometric means of CA125, CA15.3, and HE4. CA72.4 above vs. below limit of detection was evaluated using logistic regression. Early detection prediction was modeled using conditional logistic regression.ResultsCA125 concentrations were lower, and CA15.3 higher, in post- vs. premenopausal women (p ≤ 0.02). Among postmenopausal women, CA125 was higher among women with higher parity and older age at menopause (ptrend ≤ 0.02), but lower among women reporting oophorectomy, hysterectomy, ever use of estrogen-only hormone therapy, or current smoking (p < 0.01). CA15.3 concentrations were higher among heavier women and in former smokers (p ≤ 0.03). HE4 was higher with older age at blood collection and in current smokers, and inversely associated with OC use duration, parity, and older age at menopause (≤ 0.02). No associations were observed with CA72.4. Adjusting for correlates of the markers in prediction models did not improve the discrimination.ConclusionsThis study provides insights into sources of variation in ovarian cancer early detection markers in healthy women and informs about the utility of individualizing marker cutpoints based on epidemiologic factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s13048-017-0315-6) contains supplementary material, which is available to authorized users.

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“…Karabacak et al. (14) reported that 100 μ g of transdermal oestradiol significantly increased (70%) serum CA 125 levels, suggesting that the source of this increase was the endometrium, even if CA 125 levels in the study group were in the normal range. In this report, a hysteroscopy showed a thickening of endometrium, confirmed by biopsy.…”

Section: Discussionmentioning

confidence: 89%

Increased levels of CA 125 and CA 19·9 serum tumour markers following cyclic combined hormone replacement therapy

Cecchi¹,

Lapi

Vannacci

et al. 2009

Journal of Clinical Pharmacy and Therapeutics

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We report a case of increase in serum tumour markers CA 125 and CA 19.9 induced by cyclic combined hormone replacement therapy (HRT). A 52-year-old Caucasian post-menopausal woman presented with a slight enlargement of the right ovary and uterine fibromyomatosis. She was taking HRT for 4 years in a cyclic combined regimen of 2 mg oestradiol with 1 mg cyproterone acetate. The serum tumour markers occasionally measured were in normal range except CA 19.9 (997 U/mL; normal values 0.0-37) and CA 125 (85 U/mL; normal values 0.0-35). However, on one occasion, the CA 19.9 and CA 125 were high and then showed persistently high values (1005 and 81.3 U/mL, respectively). Radiodiagnostic investigations excluded any malignancies and a hysteroscopy showed endometrial thickening. After discontinuation of HRT, CA 125 levels returned to normal after 1 month, whereas CA 19.9 took 6 months to do so. Four months after the beginning subsequent therapy with over-the-counter phyto-oestrogens a new serum test showed an increase in CA 19.9 but CA 125 remained within the normal range. Phyto-oestrogen therapy was then interrupted and 1 month later CA 19.9 returned to normal. In this case, cyclic HRT was the probable cause of CA 19.9 and CA 125 increase. Positive dechallenge and subsequent CA 19.9 increase after phyto-oestrogen intake seem to confirm the role of oestrogens as the cause of the endometrial thickening through hormonal imbalance. Increased CA 19.9 and CA 125 levels in benign gynaecological conditions may be a source of misdiagnosis of malignant disease.

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Influence of exogenous estrogen administration on serum CA‐125 originating from the endometrium

Abstract: These results suggest that endometrial CA-125 secretion to serum is dependent on the dose of administered exogenous estrogen.

Cited by 4 publications

References 5 publications

The epidemiology of CA-125 in women without evidence of ovarian cancer in the Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) Screening Trial

The epidemiology of CA-125 in women without evidence of ovarian cancer in the Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) Screening Trial

Correlates of circulating ovarian cancer early detection markers and their contribution to discrimination of early detection models: results from the EPIC cohort

Increased levels of CA 125 and CA 19·9 serum tumour markers following cyclic combined hormone replacement therapy

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