A Case of Bronchiectasis with Elevated Serum CA 125 Level

PURPOSE: To determine an accurate definition for progression of ovarian cancer in patients with a persistently elevated serum CA-125. PATIENTS AND METHODS: A retrospective analysis was performed on 300 patients with epithelial ovarian carcinoma with at least one measurement of CA-125. The date of progression according to clinical or radiologic criteria was ascertained in the 88 patients with persistently elevated CA-125 levels (> 23 U/mL). This was compared with the date of progression according to CA-125, defined as the date on which the CA-125 level first increased to ≥ twice its nadir level, confirmed by a second sample also ≥ twice the nadir. RESULTS: Eighty of the 88 patients had evidence of progression by both standard and CA-125 criteria, giving a sensitivity of 94%. In six of these patients, no sample was taken to confirm CA-125 doubling. In 13 patients, CA-125 doubling occurred after the date of clinical progression. Only one patient had a false-positive prediction of progression according to CA-125; the patient died as a result of a myocardial infarct before evidence of clinical progression. CONCLUSION: In patients whose CA-125 level decreases to normal after chemotherapy, a doubling from the upper limit of normal has been shown to predict progression. In those with persistently elevated levels, doubling of CA-125 from its nadir level has now been shown to accurately define progression. If confirmed, these CA-125 criteria should be used as additional end points in clinical trials.

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Meigs' syndrome with elevated CA 125: case report

Sao Paulo Medical Journal ◽

10.1590/s1516-31802003000500007 ◽

2003 ◽

Vol 121 (5) ◽

pp. 210-212 ◽

Cited By ~ 10

Author(s):

Sabas Carlos Vieira ◽

Leonardo Halley Carvalho Pimentel ◽

José Carlos Castelo Branco Ribeiro ◽

Argemiro Ferreira de Andrade Neto ◽

Jerúsia Oliveira Ibiapina de Santana

Keyword(s):

Case Report ◽

Pleural Effusion ◽

Ovarian Tumor ◽

Frozen Section ◽

Transvaginal Ultrasound ◽

Elevated Serum ◽

Ca 125 ◽

Brazilian Woman ◽

Thoracic Drainage ◽

Benign Ovarian Tumor

CONTEXT: Meigs' syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum CA 125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs' syndrome can also have elevated serum CA 125 levels. The authors report a case of Meigs' syndrome with elevated CA 125 level. OBJECTIVE: This is a case report of Meigs' syndrome with elevated CA 125 level. CASE REPORT: A 65-year-old Brazilian woman had presented progressive dyspnea, weight loss and decline in general condition over the 7 months preceding admission to our service. In another hospital, the patient had been submitted to thoracic drainage due to pleural effusion. With recurrence of the pleural effusion and increase in abdominal volume due to ascites and a pelvic mass, the patient sought our service. Transvaginal ultrasound showed an extensive adnexal solid mass of 16.4 x 10.8 cm located in the pelvis without exact limits, and the serum CA 125 level was elevated. With a preoperative diagnosis of ovarian carcinoma, the patient was submitted to exploratory laparotomy, which revealed a left ovarian tumor. The frozen section diagnosis was thecoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The histology of the specimen confirmed the diagnosis of thecoma. The patient was asymptomatic with a normal serum CA 125 level 20 months after the operation.

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Clinical Implications of CA 125 Elevation in Patients with Cardiac Amyloidosis: An Observational Study

10.21203/rs.3.rs-202184/v1 ◽

2021 ◽

Author(s):

Muzheng Li ◽

Zhijian Wu ◽

Ilyas Tudahun ◽

Qiuzhen Lin ◽

Na Liu ◽

...

Keyword(s):

Overall Survival ◽

Cardiac Troponin ◽

Cardiac Amyloidosis ◽

Troponin T ◽

Elevated Serum ◽

Common Finding ◽

Ca 125 ◽

Control Group ◽

Clinical Implications ◽

Cardiac Troponin T

Abstract Aims: The level of serum carbohydrate antigen 125 (CA 125) elevated is a common finding in patients with cardiac amyloidosis in clinical practice. It is unclear whether CA 125 is correlated with cardiac amyloidosis. The aim of this study was to systematically evaluate the clinical implications of CA 125 elevation in patients with cardiac amyloidosis.Methods and Results: We enrolled 101 patients diagnosed with cardiac amyloidosis at the Second Xiangya Hospital, 41 patients with acute decompensated heart failure (AHF) and 39 patients with multiple myeloma (MM) who were confirmed to have no cardiac amyloidosis served as control group, respectively. In 101 patients with cardiac amyloidosis, 58 (57%) patients had elevated serum CA 125 levels, which the mean age was 61.2 ± 11.4 years. Patients with high CA 125 were more likely to present with polyserositis ( 79.3% vs 60.5%, p = 0.03) , higher levels of hemoglobin (117.22 ± 21.87 g/L vs. 106.07 ± 25.15 g/L, p = 0.01), serum potassium (4.17 ± 0.49 mmol/L vs. 3.98 ± 0.41 mmol/L, p = 0.05), low density lipoprotein-cholesterol (2.98 ± 1.65 mmol/L vs. 2.22 ± 1.10 mmol/L, p = 0.01), and cardiac troponin T (115 pg/mL vs. 59.52 pg/mL, p = 0.005) . The serum CA 125 levels were significantly higher in cardiac amyloidosis than AHF and MM. The median overall survival for patients with elevated and normal serum CA125 were 5 and 20 months, respectively (p = 0.012). According to multivariate Cox hazard analysis, CA 125 (HR 1.002, 95%CI 1.000-1.004, p = 0.020) contributed to all-cause mortality. The time-dependent receiver operating characteristic was used to reflect the accuracy of different biomarkers in predicting overall survival at various time points by the area under the curve (AUC). CA 125 has no worse prediction accuracy than cardiac troponin T, NT-proBNP and LDH according to the AUC.Conclusions: The prevalence of elevated serum CA 125 levels is more than 50% in patients with cardiac amyloidosis. As an independent prognostic predictor, highly serum CA 125 values indicated the lower overall survival and the accuracy of predicting prognosis was not inferior to the other biomarkers.

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A Case of Meigs` Syndrome with Elevated Serum CA 125 Level

Korean Journal of Gynecologic Oncology and Colposcopy ◽

10.3802/kjgoc.1998.9.3.316 ◽

1998 ◽

Vol 9 (3) ◽

pp. 316

Author(s):

Ji Young Lee ◽

Kwan Young Oh ◽

Jin Hee Son ◽

Soo Youn Kim ◽

Seung Cheol Kim

Keyword(s):

Elevated Serum ◽

Ca 125

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Peritoneal tuberculosis with elevated serum CA 125 levels: A case report

Gynecologic Oncology ◽

10.1016/0090-8258(87)90182-x ◽

1987 ◽

Vol 28 (3) ◽

pp. 342-344 ◽

Cited By ~ 19

Author(s):

Toshihiro Yoshimura ◽

Hitoshi Okamura

Keyword(s):

Case Report ◽

Elevated Serum ◽

Ca 125 ◽

Peritoneal Tuberculosis

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OVX1 radioimmunoassay complements CA-125 for predicting the presence of residual ovarian carcinoma at second-look surgical surveillance procedures.

Journal of Clinical Oncology ◽

10.1200/jco.1993.11.8.1506 ◽

1993 ◽

Vol 11 (8) ◽

pp. 1506-1510 ◽

Cited By ~ 34

Author(s):

F J Xu ◽

Y H Yu ◽

L Daly ◽

K DeSombre ◽

L Anselmino ◽

...

Keyword(s):

Ovarian Cancer ◽

Cancer Patients ◽

Elevated Serum ◽

Ca 125 ◽

Serum Samples ◽

Persistent Disease ◽

Second Look ◽

Normal Individuals ◽

Positive Results ◽

Apparently Healthy

PURPOSE At second-look surgical surveillance procedures, normal CA-125 levels can be associated with persistent disease in 50% to 60% of patients. A novel radioimmunoassay (RIA) has been evaluated for the ability to identify patients with persistent disease who have normal levels of CA-125. MATERIALS AND METHODS The OVX1 double-determinant assay used a murine monoclonal antibody to detect an epitope on a high-molecular weight mucin-like glycoprotein. RESULTS Apparently healthy individuals had serum OVX1 levels of 2.23 +/- 2.48 U/mL (mean +/- SD). Elevated serum OVX1 levels (> 7.2 U/mL) were found in 5% of 184 normal individuals and in 70% of 93 epithelial ovarian cancer patients with clinically evident disease. Among sera from these ovarian cancer patients, OVX1 was elevated in 68% of 76 samples with CA-125 levels more than 35 U/mL and in 76% of 17 samples with CA-125 levels less than 35 U/mL. In serum samples obtained at the time of positive second-look laparotomy, 59% of 41 patients with CA-125 levels less than 35 U/mL had elevated OVX1 antigen levels, whereas 41% of 22 patients with CA-125 levels more than 35 U/mL had elevated serum OVX1 levels. In patients with negative second-look laparotomies, false-positive results were eliminated by increasing the threshold of OVX1 to 10.5 U/mL. At this level, 32% of 41 patients with positive second-look operations had an elevated OVX1 level, despite a normal CA-125 level. When used in combination, CA-125 (> 35 U/mL) and OVX1 (> 10.5 U/mL) detected persistent disease in 56% of 63 patients with positive surveillance procedures, compared with 35% when CA-125 was used alone (P < .05). CONCLUSION An elevated OVX1 level can alert oncologists to the possibility that ovarian cancer has persisted, despite the return of CA-125 to a normal range.

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A Case of Peritoneal-Pelvic Tuberculosis With Elevated CA-125; An Enigma as Ovarian Cancer

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v18i2.22390 ◽

2019 ◽

Vol 18 (2) ◽

pp. 60-63

Author(s):

Prakash Raj Oli ◽

Rosy Vaidya Malla ◽

Kavita Karmacharya

Keyword(s):

Ovarian Cancer ◽

Differential Diagnosis ◽

Abdominal Pain ◽

Young Women ◽

Adnexal Mass ◽

Elevated Serum ◽

Young Lady ◽

Ca 125 ◽

Rare Form ◽

Menstrual Irregularities

Peritoneal-pelvic tuberculosis is a rare form of extrapulmonary-TB mainly affecting women of 20-40 years, especially in TB endemic countries. It classically presents with abdominal pain, menstrual irregularities, adnexal mass, and elevated serum CA-125 level, creating confusion with genital malignancy, especially ovarian one leading to difficulty in its management and often leads to devastating surgeries. Here's a case of peritoneal-pelvic TB, a young lady with abdominal pain, radiologic associates and adnexal mass, and elevated serum CA-125 level is presented. So, it should always be one of the differential diagnosis of ovarian cancer especially among young women in TB endemic countries.

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