CA125 normalization within 60 days as an independent prognostic factor for patients with advanced epithelial ovarian cancer

BACKGROUND: CA125 level normalization at different chemotherapy cycles has been reported to be a prognosticator in advanced epithelial ovarian cancer. OBJECTIVE: In the present study, we investigated whether the time (in days) to CA125 normalization or nadir during treatment could be used as markers to predict survival. METHODS: Patients with FIGO stage III–IV epithelial ovarian cancer treated with cytoreductive surgery followed by adjuvant chemotherapy between 2008 and 2016 were enrolled in this retrospective study. Clinicopathological characteristics, changes in CA125 level during treatment, and survival outcomes were analyzed. Time-dependent receiver operating characteristic curve analysis was used to determine the optimal cut-off values of the time to normalization and time to nadir of CA125 levels to predict survival. Univariate and multivariate Cox regression analysis were used to examine the impact of each variable on survival. RESULTS: A total of 106 patients were included in the analysis. The optimal cut-off values for the time to normalization and nadir for predicting survival were 60 and 194 days, respectively. In Kaplan-Meier survival analysis, CA125 level normalization ⩽ 60 days and CA125 ⩽ 35 u/mL after the third cycle, and CA125 level ⩽ 10 u/mL after the sixth cycle of chemotherapy were associated with significantly better 5-year progression-free survival (PFS) and overall survival (OS). In multivariate analysis, only CA125 level normalization > 60 days was significantly associated with poor survival outcomes (PFS, HR 2.62 [95% CI: 1.54, 4.45], p= 0.004; OS, HR 2.40 [95% CI: 1.19, 4.81], p= 0.014). CONCLUSIONS: Normalization of CA125 level within 60 days after cytoreductive surgery followed by adjuvant chemotherapy in patients with advanced ovarian epithelial cancer could be used as a marker to predict survival.

CA125: A superior prognostic biomarker for colorectal cancer compared to CEA, CA19-9 or CA242

OBJECTIVES: The tumor stage represents the single most important prognostic factor for colorectal cancer (CRC), although more accurate prognostics remain much needed. Previously, we identified CA125 as an independent significant prognostic factor, which we have further validated along with CEA, CA19-9, and CA242 in a large cohort of CRC patients. METHODS: Using enzyme-linked immunosorbent assays, we analyzed preoperative serum samples in 322 CRC patients operated on between 1998 and 2003. RESULTS: Using the Spearman’s rho model, we calculated the correlation between our previous findings on MUC16 and CA125, for which the correlation coefficient was 0.808 (p < 0.001). The Cox regression analysis of the linear and logarithmic values of CEA, CA125, CA242, and CA19-9 identified only CA125 (hazard ratio [HR] 1.03; 95% confidence interval [95% CI] 1.02−1.04; p < 0.001) as significant when using the linear values. Survival among CRC patients with a high CA125 level was poor compared with CRC patients with a low CA125 level (HR 2.48; 95% CI 1.68–3.65; p < 0.001). In subgroup analyses, patients with high CA125 levels and aged ≤67 or >67, with stage I–II or III–IV, and both colon and rectal cancer exhibited poor prognoses. In the multivariate analysis, we used clinical pathological variables in the model, where age, gender, and stage served as the background characteristics. We dichotomized CA125 using the Youden maximal cutoff point, and the median values for CEA, CA19-9, and CA242. CA125 emerged as the only marker remaining significant and independent together with stage, location, and age (HR 1.91; 95% CI 1.24–2.95; p 0.003). CONCLUSIONS: CA125 represents a significant and independent prognostic factor in CRC patients, superior to CEA. Furthermore, CA242 served as a better prognostic marker than both CEA and CA19-9. We recommend including both CA125 and CA242 in prognostic clinical trials among CRC patients.

Prognostic Value of CA125 Serum Levels in Female Patients with Acute Coronary Syndrome

Background: carbohydrate antigen 125 (CA125) is an increasingly promising biomarker of heart failure (HF), but its prognostic value in female patients with acute coronary syndrome (ACS) is unclear. We aimed to determine the short-term and mid-term prognostic value of CA125 serum levels in female ACS patients.Methods: A total of 131 consecutive female patients with ACS were retrospective enrolled. Their CA125 levels, B-type natriuretic peptide (BNP) levels and biochemical parameters were measured, and echocardiography was performed at admission. All-cause mortality during hospitalization and two-year follow-up was investigated for the prognosis.Results: The median value of CA125 serum level in the entire ACS patients was 13.85 U/mL. Patients in Killip Ⅲ had the highest values of CA125 level, followed by Killip Ⅱ and then Killip Ⅰ (p < 0.05). However, no statical difference was observed between Killip Ⅳ and Ⅰ-Ⅲ groups respectively (P > 0.05). The CA125 serum levels showed weak positive correlation with left ventricular end-diastolic diameter (LVEDD) (r = 0.3, P < 0.01) and a weak negative correlation with left ventricular ejection fraction (LVEF) (r = –0.23, p < 0.01). A receive operating characteristic (ROC) curve analysis showed that the AUC of CA125 in predicting acute heart failure (AHF) in ACS patients during hospitalization was 0.912, exhibiting higher sensitivity and specificity than BNP (0.846). The optimal cut-off value for CA125 in predicting AHF was 16.4 U/mL with a sensitivity of 0.916 and specificity of 0.893. The Kaplan-Meier survival analysis demonstrated that patients with high values of CA125 level had a poor overall survival than those with low values of CA125 level (log-rank, p < 0.001), whether during hospitalization or mid-term follow-up. Conclusion: Elevated CA125 level can be used to predict AHF in female ACS patients. Patients with elevated CA125 levels had higher mortality in short-term and mid-term than those with low CA125 levels.

Effect of Body Mass Index on Serum CA125 Level in Females with PCOS

CA125 is a glycoprotein mucins (MUC16) tumor marker, used in screening, ovarian and endometrial malignancies and in monitoring therapy, early recurrences, and prognosis of these cancers. Hormonal induction for ovulation can elevate the risk of ovarian cancers so CA125 may be used for screening in PCOS as an unsafe group and the way of treatment may need to be changed in these patients. Polycystic Ovarian Syndrome (PCOS) is one of the most common hormonal disturbed diseases that can affect females in reproductive life. It has both metabolic and fertility impacts that can be seen in the reproductive period and post-menopausal life. To study the correlation between PCOS and CA125 level in relation to body weight in non-cancerous patients. 60 women were selected with age 18-42-year-old forty of them were diagnosed with PCOS according to Rotterdam criteria. They were divided into two groups according to BMI G1 was more than 25 kg/m2 (overweight and obese) G2 was less than 25 kg/m2 (normal) and the G3 was 20 healthy non-PCOS BMI less than 25 kg/m2. Blood samples were taken in the early follicular phase for assessing luteinizing hormone (LH), follicular stimulating hormone (FSH) and, free testosterone (FT) hormone. Other blood samples were taken at the late follicular phase to measure CA125 levels using Enzyme-Linked Immune Sorbent Assay (ELISA). PCOS G2 were significantly higher in the concentration of CA125 than PCOS G1 (p< 0.05), but there was no significant difference in CA125 level in groups when there is no significant difference in body mass index (BMI) between PCOS G1 and G2. P>0.05. The negative relation between CA125 concentration and weight. The tumor marker CA125 efficacy is decreased in obese women. Furthermore, PCOS not causes an increase in CA125 in the non-cancerous patient.