SERUM CA-125 IS OF CLINICAL-VALUE IN THE STAGING AND FOLLOW-UP OF PATIENTS WITH NON-HODGKINS-LYMPHOMA - CORRELATION WITH TUMOR PARAMETERS AND DISEASE-ACTIVITY

BACKGROUND. CA 125 is a glycoprotein produced by epithelial ovarian tu mors and by mesothelial cells; its levels also have been shown to be e levated in patients with non-Hodgkin's lymphoma (NHL). METHODS. The au thors evaluated serum CA 125 levels in patients with NHL to elucidate the frequency of this finding, its relationship with other presenting features, and its potential role as tumor marker. One hundred and fift y-seven patients underwent the first CA 125 assessment at onset, 54 at disease recurrence or progression, and 62 during complete remission ( CR). RESULTS. Of the 157 patients evaluated at diagnosis (median CA 12 5: 26 U/mL; range, 2-1400 U/mL), 63 (40%) had increased CA 125 values. Higher CA 125 levels were associated with advanced disease, aggressiv e histology, mediastinal and/or abdominal involvement, bulky tumor, hi gh tumor burden, effusions, contiguous extranodal extension, high seru m lactate dehydrogenase (LDH) activity, and elevated beta 2-microglobu lin (beta 2-M) levels. Parameters identified by multivariate analysis to be independently associated with high CA 125 were: aggressive histo logy, mediastinal and/or abdominal disease, bulky tumor, high serum LD H activity and beta 2-M serum levels, and the presence of effusion (P = 0.0000; explained variation = 0.64). Of the patients presenting with abnormal CA 125 levels, all those who achieved a CR (35) and 3 of the 6 who achieved a partial response had normalization of CA 125 values by the end of treatment. Conversely, CA 125 remained above normal valu es in 18 nonresponders. All 62 patients evaluated during CR showed nor mal CA 125 levels. Among patients first evaluated at disease recurrenc e or progression, 22 of 54 (41%) showed increased CA 125 levels, which were associated with the same parameters of disease found in patients examined at diagnosis. CONCLUSIONS. High serum CA 125 levels were fou nd to correlate with mediastinal and/or abdominal involvement, high tu mor mass, and effusions, reflecting the reaction of mesothelial cells to the tumor. Serum CA 125 is a reliable biologic marker for the stagi ng and restaging of patients with lymphoma. Serial measurements are us eful, in conjunction with other markers, for monitoring response to tr eatment. (C) 1998 American Cancer Society.