Serum CA 125 as a prognostic factor in non-Hodgkin's lymphoma.
Cancer antigen 125 (CA 125) is a glycoprotein expressed in normal tissues originally derived from coelomic epithelia such as peritoneum, pleura, pericardium, fallopian tubes and endometrium. Serum CA 125 levels are elevated in various benign and malignant conditions that involve stimulation of these tissues. Although elevated levels have been reported in patients with non-Hodgkin's lymphoma (NHL), its role as a prognostic factor remained uncertain. In this study, serum CA 125 levels were measured prospectively in 108 consecutive patients with NHL: at diagnosis in 106, in remission in 39 and at relapse in 7. Levels were elevated in 43% at diagnosis. This finding was associated with advanced disease stage, bulky tumors, bone marrow involvement, extranodal disease (in stages III and IV), occurrence of B symptoms, pleural or peritoneal effusions, high serum LDH levels, high serum beta2 microglobulin (beta2-M) levels, elevated International Prognostic Score, poor performance status and partial or no response to treatment. No difference in CA 125 level was found between the indolent and aggressive lymphomas. Serum CA 125 levels at diagnosis had strong association with event-free and overall survival (p = 0.01 and 0.003, respectively), with the patients with increased levels having worse survival. Patients with high CA 125 levels at diagnosis who achieved remission showed a significant decrease in CA 125 levels in remission. In conclusion, CA 125 is not only a reliable marker for staging and assessing tumor activity in NHL, elevated levels are also predictive of decreased survival.
Bairey
Osnat
O
Institute of Hematology and Felsenstein Medical Research Center, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel. obairey@post.tau.ac.il
Blickstein
Dorit
D
Stark
Pinhas
P
Prokocimer
Miron
M
Nativ
Hila Magen
HM
Kirgner
Ilia
I
Shaklai
Mati
M
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008228:Lymphoma, Non-Hodgkin / Q000097:blood* / Q000145:classification / Q000175:diagnosis*; D008297:Male; D009367:Neoplasm Staging; D010490:Pericardial Effusion / Q000209:etiology; D016066:Pleural Effusion, Malignant / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D015996:Survival Rate; D001613:beta 2-Microglobulin / Q000032:analysis
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D001613:beta 2-Microglobulin; D007770:L-Lactate Dehydrogenase