title: Elevation of CA 125 and CA 19-9 in patients with end-stage liver disease.
abstract: BACKGROUND
  The serum tumor markers CA 19-9 and CA 125 are the serologic markers used for the monitoring of biliopancreatic and ovarian cancer, respectively. They are reported to be elevated in a variety of nonneoplastic clinical situations, including end-stage liver disease (ESLD). However, their prevalence and degree of elevation in patients with ESLD remained unclear.
  
  
  OBJECTIVE
  To examine the prevalence and degree of elevation of CA 19-9 and CA 125 in patients with ESLD and to determine their association with severity of liver disease.
  
  
  METHODS
  Retrospective analysis of 161 patients with ESLD that were evaluated for liver transplantation at our institution between March 2009 and December 2010. The mean age was 55.15 ± 8.75 years and 107 (66.4%) of the patients were men. Serum CA 19-9 and CA 125 levels were determined during evaluation of their candidacy for liver transplantation.
  
  
  RESULTS
  Eighty-three (51.5%) patients had elevated CA 125 and 44 (53%) of them had a serum concentration >5 times the upper limit of normal (ULN). Elevated CA 125 was associated with alcoholic liver disease, high Model for End-Stage Liver Disease (MELD) score, and presence of ascites. Similarly, 37 (23%) patients had elevated CA 19-9 and 8 (21.6%) of them had a serum concentration >5 times ULN. Elevation of CA 19-9 was associated with high MELD score.
  
  
  CONCLUSIONS
  CA 125 and CA 19-9 concentrations were elevated in 51.5% and 23% of patients with ESLD, respectively. Although the definite etiology remained unclear, their elevation was associated with the pathological conditions associated with advanced liver disease. Further studies are needed to clarify the underlying mechanism(s) responsible for their increased levels.
authors.affiliation: Division of Abdominal Organ Transplantation, Department of Surgery, Temple University Hospital, Philadelphia, PA 19140, USA.
authors.forename: Ashish
authors.initials: A
authors.lastname: Singhal
authors.forename: Elaine
authors.initials: E
authors.lastname: Lander
authors.forename: Andreas
authors.initials: A
authors.lastname: Karachristos
authors.forename: Ellen
authors.initials: E
authors.lastname: Daly
authors.forename: Phyllis
authors.initials: P
authors.lastname: Dowling
authors.forename: Vishal
authors.initials: V
authors.lastname: Patel
authors.forename: Manoj
authors.initials: M
authors.lastname: Maloo
authors.forename: Ashokkumar
authors.initials: A
authors.lastname: Jain
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D058625:End Stage Liver Disease / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen