The utility of tumor markers CA 125, CA 15-3, and CA 19-9 in assessing the response to therapy in pulmonary and pleural tuberculosis

Abstract

Aim:Both of the diagnosis and treatment evaluation are time-consuming conditions in patients with pulmonary and pleural tuberculosis. The aim of this study was to establish the validity of tumor markers CA 125, CA 15-3, and CA 19-9 in the diagnosis of pulmonary and pleural TB and to verify the success of the treatment protocol.Patients and methods:The levels of tumor markers CA 125, CA 15-3, and CA 19-9 were measured before and after treatment in 67 TB patients, 54 of whom had pulmonary TB and 13 of whom had pleural TB. All values were compared with the results of a healthy control group of 44 subjects.Results:CA 125 and CA 15-3 levels were significantly high when compared with those of the healthy control group and there was a significant decrease in both tumor marker levels after treatment in patients with pulmonary TB (P < 0.001 and P < 0.004, respectively). However, the difference found in CA 19-9 levels before and after treatment in patients with pulmonary TB was not statistically significant (P < 0.08). When the CA 125, CA 15-3, and CA 19-9 values of the pulmonary TB group before treatment were compared with that of the healthy control group, the results were statistically significant in all parameters except CA 19-9 (P < 0.001, P < 0.001, and P < 0.09 for CA 125, CA 15-3, and CA 19-9, respectively). In the patients with pleural TB, CA 125, CA 15-3, and CA 19-9 values did not change significantly after treatment.Conclusion:The authors suggest that CA 125 and CA 15-3 tumor markers may be important for verification of the success of treatment protocol in pulmonary TB, as the differences found for these tumor markers between the pre- and the posttreatment periods are statistically significant.

Serum CA-125 for the diagnosis of pulmonary tuberculosis: a systematic review and meta-analysis

“…Ichiki et al found elevated serum CA-125 levels in 44.4% of patients with active PTB; after treatment with antituberculosis drugs, mean serum CA-125 levels significantly decreased [ 36 ]. Tascı et al from Turkey observed that the serum CA-125 levels of PTB patients are significantly higher than those of healthy controls [ 37 ]. A significant decrease in serum CA-125 levels was observed after anti-TB treatment; however, if the serum CA-125 level was lower than 35 U/ml prior to treatment, the reduction achieved following anti-TB treatment was not significant [ 37 ].…”

“…Tascı et al from Turkey observed that the serum CA-125 levels of PTB patients are significantly higher than those of healthy controls [ 37 ]. A significant decrease in serum CA-125 levels was observed after anti-TB treatment; however, if the serum CA-125 level was lower than 35 U/ml prior to treatment, the reduction achieved following anti-TB treatment was not significant [ 37 ]. The group also found that patients with a higher degree of sputum smear positivity have higher serum CA-125 levels [ 37 ].…”

“…Although previous studies suggested that serum CA-125 levels could assist in diagnosing active PTB and monitoring therapeutic responses [ 4 , 6 – 8 , 20 , 21 , 27 – 29 , 32 , 37 , 38 ] and may be related to the severity of PTB [ 7 , 8 , 37 ], caution must be exercised when applying this finding to clinical practice. First, several studies have also reported that the proportion of PTB patients with elevated serum CA-125 levels is not especially high (38–45%) [ 4 , 8 , 36 ], which suggests that the serum CA-125 levels of most PTB patients may not be elevated.…”