Indian Journal of Clinical Biochemistry

, Volume 18, Issue 2, pp 27–33 | Cite as

Determination of cancer antigen 125 in ovarian carcinoma

  • V. Thakur
  • A. K. Anand
  • U. Mukherjee
  • D. Ghosh


Appropriate therapeutic measures can improve the life expectancy of patients with ovarian malignancy. There has been a pressing need for serodiagnostic assays to enable, the close patient monitoring. Cancer Antigen 125 (CA125) has been described as a useful marker in patient monitoring for ovarian malignancy. Keeping this in view, the present study was planned. 40 consecutive female patients of ovarian carcinoma (mean age 52.4±10.7 years) were selected for serum CA125 analysis during the period of year 1995–2001. The tumour marker concentration was compared with histologic types of ovarian tumour and the FIGO staging of the disease. 25 healthy females (mean age 35.2–10.4 years) served as control. Mean serum CA125 concentrations in patients with papillary serous adenocarcinoma(Mean±%CV 1571±121.5 U/ml) was much higher than patients with mucinous adenocarcinoma(775±78U/ml). Mean serum CA125 concentration in endometrioid carcinoma was very high(2853±136 U/ml). The patient with clear cell carcinoma however had shown moderate increase(60 U/ml). No correlation was found between serum CA125 concentration and the FIGO staging of disease.

Quantitation of CA125 was most helpful in monitoring the response of treatment and followup of the patients after completion of their treatment. Posttherapeutically its concentration showed more than 50% reduction in almost all (91.4%) patients (P<0.001). Importantly these patients had also shown significant regression of the disease clinically and radiologically. 8.6% of patients had shown static or increase in serum CA125 concentration which was associated with either clinically static or progressive disease. Recurrence of the disease was noted in patients who had shown increase in serum CA125 concentration (biochemical recurrence) in the followup

However, in our test population biochemical recurrence(increase in serum marker concentration) preceded the clinical or radiological recurrence by an average of 6.5 months.

Kaplan meier survival analysis for evaluation of overall survival in our test subjects showed an overall survival of 32% at one year and median survival of 9 months with confidence interval of 6.34 to 11.66. We conclude that serum CA125 is a useful marker for monitoring the treatment and predicting an early recurrence of the disease in ovarian carcinoma patients. A study in larger number of patients is needed to define its exact role in the management of the carcinoma ovary.

Key words

Serum CA125 Epithelial tumour Ovarian Carcinoma 


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  1. 1.
    Rustin, G.J.S., Nelstrop, A., Stilwel, J. and Lambert, H.E. (1992). Savings obtained by CA125 measurements during therapy for ovarian carcinoma. Eur. J. Cancer. 28, 79–82.PubMedCrossRefGoogle Scholar
  2. 2.
    Levin, P.T., Knapp, R.C., Malkasian, G., Whitney, C.W., Besek, J.S. and Bast, R.C. (1987). CA 125 for the monitoring of ovarian carcinoma during pretreatment. Obstet. Gynecol. 69, 223–227.Google Scholar
  3. 3.
    Vergote, I.B., Bormen, O.P. and Abeler, V.M. (1987). Elevation of serum CA 125 levels in the monitoring of ovarian cancer. Am. Obstet. Gynecol. 157, 88–92Google Scholar
  4. 4.
    Redman, C.W.E., Black ledge, G.R., Kelly, K., Powell, S., Buxton, E.J. and Lueslay, D.M. (1990). Can early serum CA 125 response predict outcome in epithelial ovarian cancer? Eur. J. Cancer 26, 593–596.PubMedCrossRefGoogle Scholar
  5. 5.
    Vander Burg, M.E.L., Laumes, F.B., Van Patten, W.L.J. and Stoter, G. (1988). Ovarian cancer, the prognostic value of the serum half life of CA 125 during induction chemotherapy. Gynecol. Oncol. 30, 307–312PubMedCrossRefGoogle Scholar
  6. 6.
    Rustin, G.J.S., Gennengs, J.N., Nelstrop, A.E., Covarrubias, H., Lambert, H.E. and Bagshawe, K.D. (1987). Use of CA 125 to predict survival of patients with ovarian carcinoma. J. Clin. Oncol. 7, 1667–1671.Google Scholar
  7. 7.
    Fisken, J., Leonard, R.C.F., Stewart, F., Beattie, G.J., Sturgeon, C., Aspinall, L. and Roulston, J.E. (1993). The prediagnostic value of early CA125 serum assay in epithelial ovarian carcinoma. Br. J. Cancer 68, 140–145.PubMedGoogle Scholar
  8. 8.
    Welander, C.E. (1992) What do CA 125 and other antigen tell us about ovarian cancer biology? Acta Obstet. Gynecol. Scand. 155, 85–93.Google Scholar
  9. 9.
    Kenemans, P., Verstraetem, A.A., Van kamp, G.J. and Hinger, J. (1994). CA 125 in the management of ovarian carcinoma (Abs 562) Ann, Oncol. 5, 112.Google Scholar
  10. 10.
    Bast, R.C., Feeney, M., Lazarus, H., Nadler, L.M., Colvin, R.B. and Knalp, R.C. (1981). Reactivity of a monoclonal antibody with human ovarian carcinoma. J. Clin. Invest. 68, 1331–1337.PubMedCrossRefGoogle Scholar
  11. 11.
    Munstedt, K., Krisch, M., Sachsse, S. and Vahrson, H. (1997). Serum CA125 levels and survival in advanced ovarian cancer. Arch. Gynecol. Veslet. 259, 117–123.CrossRefGoogle Scholar
  12. 12.
    Kudoh, K., Kikuchi, Y., Kite, T., Tode, T., Takano, M., Hirata, J., Mano, Y., Yamamoto, K. and Nagata, I. (1999) Preoperative determination of several serum tumor markers in patients with primary epithelial ovarian carcinoma. Gynae. Obstet. Invest. 47, 52–57.CrossRefGoogle Scholar
  13. 13.
    Serum Cancer antigen 125 (CA125). Mayo Medical Labo Communique, 12(5), Rochester MN 1987.Google Scholar
  14. 14.
    Bast, R.C., Klug, T.L., John, E.S., Niloff, J.M., Lazarus, H., Berkowitz, R.S., Leavitt, T., Griffiths, C.T., Parker, L., Zurawski., V.R. and Knapp, R.C. (1983). A radioimmuno assay using monoclonal antibody to monitor the course of epithelial ovarian cancer. N. Engl. J. Med. 309, 883–887.PubMedCrossRefGoogle Scholar
  15. 15.
    Vander Burg, M.E.L., Myles, J.D., Hoskins, al. (1993). CA125 is an unreliable marker for monitoring response to taxol therapy in patients with relapsed ovarian cancer. Eur. J. Cancer 29A, 133 (Suppl. 6, Abstract 723).Google Scholar
  16. 16.
    Kudelka, A.P., Tresukosol, D., Edwards, C.L., Feedman, R.S., Levenback, C., Chantarawiroj, P., Leon, C.G.D., Kim, E.E., Madden, T., Wallin, H., Hord, M., Verschraegen, C., Raber, M. and Kavanagh, J.J. (1996). Phase II study of intravenous topotecan as a 5 day infusion for refractory epithelial ovarian carcinoma. J. Clin. Oncol. 14 (5), 1552–1557.PubMedGoogle Scholar

Copyright information

© Association of Clinical Biochemists of India 2003

Authors and Affiliations

  • V. Thakur
    • 1
  • A. K. Anand
    • 2
  • U. Mukherjee
    • 1
  • D. Ghosh
    • 2
  1. 1.Biochemistry Unit, Department of Laboratory MedicineBatra Hospital & Medical Research centreNew DelhiIndia
  2. 2.Department of OncologyBatra Hospital & Medical Research CentreNew DelhiIndia

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