Cargando…

CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study

Background and Aims: To evaluate the prevalence and significance of elevated cancer antigen-125 (CA-125) levels in patients with cirrhosis being treated in a tertiary care liver center and its correlation with objective markers of disease severity. Methods: We retrospectively reviewed medical record...

Descripción completa

Detalles Bibliográficos
Autores principales: Edula, Raja GR, Muthukuru, Sujit, Moroianu, Serban, Wang, Yucai, Lingiah, Vivek, Fung, Phoenix, Pyrsopoulos, Nikolaos T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: XIA & HE Publishing Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160305/
https://www.ncbi.nlm.nih.gov/pubmed/30271734
http://dx.doi.org/10.14218/JCTH.2017.00070
_version_ 1783358747208318976
author Edula, Raja GR
Muthukuru, Sujit
Moroianu, Serban
Wang, Yucai
Lingiah, Vivek
Fung, Phoenix
Pyrsopoulos, Nikolaos T
author_facet Edula, Raja GR
Muthukuru, Sujit
Moroianu, Serban
Wang, Yucai
Lingiah, Vivek
Fung, Phoenix
Pyrsopoulos, Nikolaos T
author_sort Edula, Raja GR
collection PubMed
description Background and Aims: To evaluate the prevalence and significance of elevated cancer antigen-125 (CA-125) levels in patients with cirrhosis being treated in a tertiary care liver center and its correlation with objective markers of disease severity. Methods: We retrospectively reviewed medical records of 172 adult patients with cirrhosis (due to any etiology) after obtaining CA-125 serum analysis. Demographics, etiology of cirrhosis, model of end-stage liver disease (MELD) score, Child’s Turcotte-Pugh classification, albumin bilirubin (ALBI) score, degree of ascites, presence of esophageal varices, serum CA-125 level and various other parameters were collected. Statistical analysis was performed using SPSS software and descriptive statistics. Results: Elevated CA-125 levels were noted in 147 patients (85%) of the study population. Higher MELD score was associated with higher CA-125 levels (p = 0.001). Statistically significant correlation was observed between elevated CA-125 levels and degree of ascites (p < 0.001), ALBI score (p < 0.001) and Child’s Turcotte-Pugh class (p < 0.001). No correlation was observed with presence or absence of esophageal varices. Near-normal CA-125 levels were noted in patients with cirrhosis but undetectable ascites on ultrasound imaging. No differences were observed in mean values between male and female patients (p = 0.207). Regression analysis confirmed that CA-125 levels had a better correlation with degree of ascites than MELD score or ALBI score. Conclusions: Elevated CA-125 levels were noted in 85% of patients with cirrhosis at our center. Our study establishes that the more advanced the degree of decompensation based on MELD score, Child’s Turcotte-Pugh classification and ALBI score, the higher the elevation in CA-125. Absence of ascites was associated with normal CA-125 level, with a direct correlation between high levels and worsening ascites, but there was no statistically significant correlation with esophageal varices, indicating that elevated CA-125 levels could be related to mechanical stretch of the peritoneum rather than portal hypertension itself. Further multi-centered studies are required to confirm and validate these findings.
format Online
Article
Text
id pubmed-6160305
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher XIA & HE Publishing Inc.
record_format MEDLINE/PubMed
spelling pubmed-61603052018-09-28 CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study Edula, Raja GR Muthukuru, Sujit Moroianu, Serban Wang, Yucai Lingiah, Vivek Fung, Phoenix Pyrsopoulos, Nikolaos T J Clin Transl Hepatol Original Article Background and Aims: To evaluate the prevalence and significance of elevated cancer antigen-125 (CA-125) levels in patients with cirrhosis being treated in a tertiary care liver center and its correlation with objective markers of disease severity. Methods: We retrospectively reviewed medical records of 172 adult patients with cirrhosis (due to any etiology) after obtaining CA-125 serum analysis. Demographics, etiology of cirrhosis, model of end-stage liver disease (MELD) score, Child’s Turcotte-Pugh classification, albumin bilirubin (ALBI) score, degree of ascites, presence of esophageal varices, serum CA-125 level and various other parameters were collected. Statistical analysis was performed using SPSS software and descriptive statistics. Results: Elevated CA-125 levels were noted in 147 patients (85%) of the study population. Higher MELD score was associated with higher CA-125 levels (p = 0.001). Statistically significant correlation was observed between elevated CA-125 levels and degree of ascites (p < 0.001), ALBI score (p < 0.001) and Child’s Turcotte-Pugh class (p < 0.001). No correlation was observed with presence or absence of esophageal varices. Near-normal CA-125 levels were noted in patients with cirrhosis but undetectable ascites on ultrasound imaging. No differences were observed in mean values between male and female patients (p = 0.207). Regression analysis confirmed that CA-125 levels had a better correlation with degree of ascites than MELD score or ALBI score. Conclusions: Elevated CA-125 levels were noted in 85% of patients with cirrhosis at our center. Our study establishes that the more advanced the degree of decompensation based on MELD score, Child’s Turcotte-Pugh classification and ALBI score, the higher the elevation in CA-125. Absence of ascites was associated with normal CA-125 level, with a direct correlation between high levels and worsening ascites, but there was no statistically significant correlation with esophageal varices, indicating that elevated CA-125 levels could be related to mechanical stretch of the peritoneum rather than portal hypertension itself. Further multi-centered studies are required to confirm and validate these findings. XIA & HE Publishing Inc. 2018-07-02 2018-09-28 /pmc/articles/PMC6160305/ /pubmed/30271734 http://dx.doi.org/10.14218/JCTH.2017.00070 Text en © 2018 Authors. http://creativecommons.org/licenses/by-nc/4.0/ This article has been published under the terms of Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0), which permits noncommercial unrestricted use, distribution, and reproduction in any medium, provided that the following statement is provided. “This article has been published in Journal of Clinical and Translational Hepatology at DOI: 10.14218/JCTH.2017.00070 and can also be viewed on the Journal’s website at http://www.jcthnet.com”.
spellingShingle Original Article
Edula, Raja GR
Muthukuru, Sujit
Moroianu, Serban
Wang, Yucai
Lingiah, Vivek
Fung, Phoenix
Pyrsopoulos, Nikolaos T
CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study
title CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study
title_full CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study
title_fullStr CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study
title_full_unstemmed CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study
title_short CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study
title_sort ca-125 significance in cirrhosis and correlation with disease severity and portal hypertension: a retrospective study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160305/
https://www.ncbi.nlm.nih.gov/pubmed/30271734
http://dx.doi.org/10.14218/JCTH.2017.00070
work_keys_str_mv AT edularajagr ca125significanceincirrhosisandcorrelationwithdiseaseseverityandportalhypertensionaretrospectivestudy
AT muthukurusujit ca125significanceincirrhosisandcorrelationwithdiseaseseverityandportalhypertensionaretrospectivestudy
AT moroianuserban ca125significanceincirrhosisandcorrelationwithdiseaseseverityandportalhypertensionaretrospectivestudy
AT wangyucai ca125significanceincirrhosisandcorrelationwithdiseaseseverityandportalhypertensionaretrospectivestudy
AT lingiahvivek ca125significanceincirrhosisandcorrelationwithdiseaseseverityandportalhypertensionaretrospectivestudy
AT fungphoenix ca125significanceincirrhosisandcorrelationwithdiseaseseverityandportalhypertensionaretrospectivestudy
AT pyrsopoulosnikolaost ca125significanceincirrhosisandcorrelationwithdiseaseseverityandportalhypertensionaretrospectivestudy