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CA-125 (CA125)

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EPIC Test Name

CA 125

EPIC Code

LAB155

Specimen Requirements

plasma
Minimum Volume:0.5 mL
Collection:Collect using standard laboratory procedures
Transport:Room Temperature ASAP
Stability:Refrigerated: 5 days at 2-8 degrees C
Frozen: 6 months at -20 degrees C
Container:LIT-GRN
Processing/Storage:Centrifuge pour off and freeze.
Rejection Causes:Hemolysis,
Insufficient Sample Volume, lipemic samples

Methods

Electrochemiluminescence

Turnaround Time

SpecimenTurnaround TimeFrequency
plasma5 daysRun Tuesdays and Fridays

Reference Ranges

Electrochemiluminescence
Female RangeUnit
<38 U/mLU/mL

Clinical Indications

Cancer antigen 125 (CA 125 with half life of about 5 days) is a glycoprotein antigen normally expressed in coelomic epithelia of various tissues including ovary, fallopian tube, peritoneum, pleura, pericardium, colon, kidney, stomach. Therefore, CA 125 is a unspecific marker; however, it is the most important tumor marker for monitoring the therapy and progress of patients with serous ovarian carcinoma.

Various levels of elevated CA 125 test values can occur in various clinical conditions, they are:
• Various benign gynecological diseases such as ovarian cysts, ovarian metaplasia, endometriosis, uterus myomatosus or cervicitis. Slight CA 125 elevations can also occur in early pregnancy and in various benign diseases (e.g. acute and chronic pancreatitis, benign gastrointestinal diseases, renal insufficiency, autoimmune diseases and others). Markedly CA 125 elevations have been seen in benign liver diseases such as cirrhosis and hepatitis.
• Patients with ovarian carcinoma, malignancies of the endometrium, breast, gastrointestinal tract and various other malignancies, often have the highest CA 125 values.
• Extremely high CA 125 values can occur in any kind of ascites caused by malignant and benign diseases.

Additional Information

• Elevated CA 125 results alone cannot be used as evidence of the presence or absence of disease.
• CA 125 values from using different assay methods cannot be used interchangeably, due to lack of method standardization.
• Cautions should be exercised in the interpretation of the test results for patients who have been exposed to mouse antigens, e.g., environmentally or as part of treatment or imaging procedures. Existence of antimouse antibodies in the patient body interfere with the assay reagents to produce unreliable CA 125 results.

Common Synonyms

CA125

Performed

Lab
Chemistry - Community

Interpretative Information

For monitoring, CA 125 elevated values above the reference interval after debulking surgery and chemotherapy suggest that residual disease be likely (>95% accuracy). However, normal CA 125 values cannot rule out recurrence. A study by Lee et al. demonstrated that among patients with preoperative CA-125 normalization after neoadjuvant chemotherapy, postoperative CA-125 re-elevation showed no prognostic value.
Persistently high CA 125 values suggest progressive malignant disease and poor therapeutic response.

CPT

86304

LOINC

10334-1

References

1. Davis HM, Zurawski VR Jr, Bast RC Jr, et al. Characterization of the CA 125 antigen associated with human epithelial ovarian carcinomas. Cancer Research 1986;46:6143-8.
2. Klug TL, Bast RC Jr, Niloff JM, et al. Monoclonal antibody immunoradiometric assay for an antigenic determinant (CA 125) associated with human epithelial ovarian carcinomas. Cancer Res
3. 1984;44:1048-53.
4. Hasholzner U, Baumgartner L, Stieber P, et al. Significance of the tumor markers CA 125 II, CA 72-4, CASA and CYFRA 21-1 in ovarian carcinoma. Anticancer Res 1994;14(6B):2743-6.
5. Daoud E, Bodor G, Weaver Ch, et al. (Washington University Case Conference) CA-125 Concentrations in Malignant and Nonmalignant Disease. Clin Chem 1991;37(11):1968-74.
6. Van Dalen A. Quality Control and Standardization of Tumor Marker Tests. Letter to the Editor: Tumor Biol 1993;14:131-135.
7. Lee YJ, Chung YS, Lee JY, Nam EJ, Kim SW, Kim S, Kim YT. Prognostic significance of CA-125 re-elevation after interval debulking surgery in patients with advanced-stage ovarian cancer undergoing neoadjuvant chemotherapy. Eur J Surg Oncol. 2019;45:644-9. doi: 10.1016/j.ejso.2018.10.053. Epub 2018 Oct 11. PMID: 30337203.

Contact Information

Chemistry - Community: (315)492-5531
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