Tumour Markers and Cirrhosis: The Ca-125 Who Came in From the Cold

Serum CA-125 is commonly used as a marker for ovarian cancer (1,2), although it can be elevated in nongynecological malignancy and benign gynecological disease (2).In this prospective study, serum CA-125 was measured pre-and postliver transplantation in 57 cirrhotic patients (67% men) as well as two patients with polycystic liver disease and abdominal distention without ascites.Ascitic CA-125 levels were determined in five patients who had paracentesis.Mesothelial CA-125 staining was performed in 16 hepatectomy specimens.The mean serum CA-125 level pretransplant was 352±549 U/L (normal less than 37 U/L) and 46±49 U/L post-transplant (P<0.001).The mean ascitic CA-125 was 951±322 U/L compared with the mean serum level of 619±290 U/L (P<0.003).The CA-125 mesothelial staining grade was 0.8±1.4 and 1.5±1.1 in patients with normal and elevated serum CA-125 (P=0.37).The two patients with polycystic liver disease without ascites also had elevated CA-125.On multivariate analysis, ascites was the only predictive variable for elevated serum CA-125.