A study of CA-125 in patients with pleural effusion
Egyptian Journal of Bronchology volume 9, pages 283–286 (2015)
A significant concern of physicians treating patients with pleural effusion is to rule out a malignant etiology, which, in the majority of series, is the first cause of pleural exudates. Determination of tumor markers in serum and pleural fluid has been proposed as a nonaggressive means of establishing a diagnosis of pleural malignancy. Cancer antigen 125 (CA-125) is not a specific tumor marker and it is synthesized by normal and malignant cells of different origins. Recently, it has been shown that various diseases are associated with increased CA-125 levels, especially in the presence of serosal fluid.
The aim of this study was to determine the level of serum and pleural fluid CA-125 to evaluate its value as a marker for differentiation between different types of pleural effusion.
Patients and methods
The study was carried out on 30 patients with pleural effusion of different etiologies. They were further subdivided into two groups: exudates and transudates; the levels of both serum and pleural fluid CA-125 were evaluated.
In terms of pleural CA-125, there was a statistically significant increase in the exudative subgroup compared with transudative subgroup. Furthermore, it was found that malignant effusion was observed more frequently compared with benign effusion and tuberculosis was observed more frequently in comparison with other infections.
The highest level of pleural fluid CA-125 was found in malignancy, followed by tuberculosis, and so pleural fluid CA-125 can be used as a marker for the diagnosis of pleural effusion. Egypt J Broncho 2015 9:283–286
Thickett DR, Armstrong L, Millar AB. Vascular endothelial growth factor (VEGF) in inflammatory and malignant pleural effusions. Thorax 1999; 54:707–710.
Kinasewitz GT. Pleural fluid dynamics and effusions. In: Fishman AP, Elias JA, Fishman JA, Grippi MA, Kaiser LR, Senior MR, editors. Fishman’s pulmonary diseases and disorders. New York: McGraw Hill; 1997. 1381–1409.
Yin BW, Lloyd KO. Molecular cloning of the CA125 ovarian cancer antigen: identification as a new mucin, MUC16. J Biol Chem 2001; 276:27371–27375.
Shokouhi Sh, Abadi M, Gachkar L. Pleural fluid CA-125 in patients with pleural effusion. Tanaffos 2005; 4:23–27.
Rusch VW, Venkatraman ES. Important prognostic factors in patients with malignant pleural mesothelioma, managed surgically. Ann Thorac Surg 1999; 68:1799–1804.
Cacciotti P, Strizzi L, Vianale G, Iaccheri L, Libener R, Porta C, et al. The presence of simian-virus 40 sequences in mesothelioma and mesothelial cells is associated with high levels of vascular endothelial growth factor. Am J Respir Cell Mol Biol 2002; 26:189–193.
How SH, Liam CK, Jamalludin AR, Chin SP, Zal AB. Serum cancer antigen 125 in patients with pleural effusions. Med J Malaysia 2006; 61:558–563.
Kalantri Y, Naik G, Joshi SP, Jain A, Phatak S, Chavan R, et al. Role of cancer antigen-125 from pleural & ascitic fluid samples in non malignant conditions. Indian J Med Res 2007; 125:25–30.
Aoki Y, Katoh O, Nakanishi Y, Kuroki S, Yamada H. A comparison study of IFN-gamma, ADA, and CA125 as the diagnostic parameters in tuberculous pleuritis. Respir Med 1994; 88:139–143.
Tomita Y. Clinical evaluation and tissue distribution of CA125 in patients with pleural effusion. Igaku Kenkyu 1989; 59:90–96.
Ferrer J, Encabo G, Vila S, Villarino MA, Felip E, Bermejo B, et al. Diagnostic utility of CYFR21–1, carcinoembryonic antigen, CA-125, neuron specific enolase and squamous cell antigen level determinations in the serum and pleural fluid of patients with pleural effusions. Cancer 1999; 86:1488–1495.
Kabawat SE, Bast RC Jr, Bhan AK, Welch WR, Knapp RC, Colvin RB. Tissue distribution of a coelomic-epithelium-related antigen recognized by the monoclonal antibody OC125. Int J Gynecol Pathol 1983; 2:275–285.
Mezger J, Lamerz R, Arnholdt H, Huhn D, Wilmanns W. Tumor-marker in diagnosis of ascites and pleura puncture fluids. Oncology 1986; 9:11–16.
Mezger J, Wilmanns W, Lamerz R. Elevated serum CA-125 levels in patients with benign ascites or pleural effusions. Tumor Biol 1988; 9:47–52.
Molina R, Filella X, Bruix J, Mengual P, Bosch J, Calvet X, et al. Cancer antigen 125 in serum and ascitic fluid of patients with liver diseases. Clin Chem 1991; 37:1379–1383.
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Shalaby, A.E.D.O., Moussa, H.A.A., Nasr, A.S. et al. A study of CA-125 in patients with pleural effusion. Egypt J Bronchol 9, 283–286 (2015). https://doi.org/10.4103/1687-8426.165936
- pleural effusion