Serum CA 125 as a Prognostic Factor in Non-Hodgkin's Lymphoma

Abstract

Cancer antigen 125 (CA 125) is a glycoprotein expressed in normal tissues originally derived from coelomic epithelia such as peritoneum, pleura, pericardium, fallopian tubes and endometrium. Serum CA 125 levels are elevated in various benign and malignant conditions that involve stimulation of these tissues. Although elevated levels have been reported in patients with non-Hodgkin's lymphoma (NHL), its role as a prognostic factor remained uncertain. In this study, serum CA 125 levels were measured prospectively in 108 consecutive patients with NHL: at diagnosis in 106, in remission in 39 and at relapse in 7. Levels were elevated in 43% at diagnosis. This finding was associated with advanced disease stage, bulky tumors, bone marrow involvement, extranodal disease (in stages III and IV), occurrence of B symptoms, pleural or peritoneal effusions, high serum LDH levels, high serum beta2 microglobulin (beta2-M) levels, elevated International Prognostic Score, poor performance status and partial or no response to treatment. No difference in CA 125 level was found between the indolent and aggressive lymphomas. Serum CA 125 levels at diagnosis had strong association with event-free and overall survival (p = 0.01 and 0.003, respectively), with the patients with increased levels having worse survival. Patients with high CA 125 levels at diagnosis who achieved remission showed a significant decrease in CA 125 levels in remission. In conclusion, CA 125 is not only a reliable marker for staging and assessing tumor activity in NHL, elevated levels are also predictive of decreased survival.

Extranodal follicular dendritic cell sarcoma in mesentery: A case report

“…However, elevated serum CA125 levels have not been observed in other reported FDC sarcomas. Although lymphoma cells do not secrete CA125, investigators have reported serum elevations of CA125 in as many as 40% of patients with non-Hodgkin's lymphoma, particularly when peritoneal, pleural or pericardial effusions were present (27). Various investigators have proposed including serum CA125 level in prognostic indices for lymphoma (28).…”

CA 125: A potential tumor marker for gallbladder cancer

“…The other malignancies reported lower sensitivity [20,21]. It is also interesting to note that CA 125 is equally sensitive and specific for gallbladder cancer as other tumor markers like CA 19-9 and CEA in GBC [22,23].…”

“…The positive association of gallbladder mass, weight loss, ascites, and loss of appetite with CA 125 was noted. Weight loss is also reported to be associated with increased CA 125 in Non Hodgkin Lymphomas [21]. Elevated CA 125 is closely related to cirrhotic ascites [26,27].…”

Isolated renal relapse of a case with non-Hodgkin’s lymphoma

“…However, approximately 40% of patients with NHL had found elevated serum CA-125 levels at diagnosis [20]. In most series CA-125 levels correlate with some features of NHL, such as stage of disease, bulky tumor, effusions, and response to therapy [20,21]. The other malignant and nonmalignant serosal fluids such as peritoneal, pleural, and pericardial effusions have been found to be associated with high serum levels of CA-125 [22].…”