title: Serum concentrations of CA 125, CA 15-3, CA 19-9 and CEA in normal pregnancy: a longitudinal study.
abstract: OBJECTIVE
  Although cancer diagnosed during pregnancy is rare, the coexistence of pregnancy and malignancy becomes more common in view of prolongation of reproductive age. Therefore, it is important that the specificity of a tumor marker be evaluated during pregnancy to avoid misinterpretation in the follow-up of a pregnant cancer patient. The present study aims to investigate the serum concentrations of CA-125, CA 15-3, CA 19-9 and CEA in healthy pregnant women through gestation.
  
  
  METHODS
  In this prospective study, we followed thirty healthy pregnant women. Blood samples were obtained during each trimester of pregnancy (10-12, 22-24 and 34-36 weeks). The maternal serum levels of CA-125, CA 15-3, CA 19-9 and CEA were measured using electrochemiluminescence immunoassay.
  
  
  RESULTS
  There was no difference between the first and second trimester serum levels of CA 125, CEA and CA 19-9. However, serum CA 125 levels in third trimester were found to be significantly elevated in pregnants compared to the second trimester (median values 19.6 vs. 15.6 IU/mL, p = 0,009). Similarly, the serum CEA levels in third trimester were significantly higher than those of second trimester (median values 1.1 vs. 0.7 ng/ml, p = 0.001). It is also found that CEA and CA 19-9 assay values were significantly elevated in the third trimester of pregnancy when compared with the first trimester of pregnancy (CEA median values 1.1 vs. 0.7 ng/ml, p = 0.02 and CA 19-9 median values 11.6 vs. 7.7 IU/mL, p = 0,02). Three trimester had statistically similar levels for serum CA 15-3 (median values 17.5, 19.7 and 18.3 U/mL, respectively). The four tumor markers assay values were found generally within the normal range.
  
  
  CONCLUSIONS
  These findings suggest that maternal serum levels of CA 125, CEA and CA 19-9 were increased during third trimester of pregnancy. However, these elevations were within the normal range. CA 15-3 is independent of gestation and reliable tumor markers in monitoring malignancy in pregnant patients.
authors.affiliation: Department of Clinical Biochemistry, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey. serifercan23@yahoo.com
authors.forename: Şerif
authors.initials: Ş
authors.lastname: Ercan
authors.forename: Özge
authors.initials: Ö
authors.lastname: Kaymaz
authors.forename: Nihal
authors.initials: N
authors.lastname: Yücel
authors.forename: Asuman
authors.initials: A
authors.lastname: Orçun
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008565:Membrane Proteins / Q000097:blood*; D018396:Mucin-1 / Q000097:blood*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood; D011262:Pregnancy Trimester, Second / Q000097:blood; D011263:Pregnancy Trimester, Third / Q000097:blood; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins; D018396:Mucin-1