Cancer antigen 125: A sensitive marker of ascites in patients with liver cirrhosis

OBJECTIVE: Cancer antigen 125 (CA 125) is a high molecular mass glycoprotei n, usually used for monitoring the course of epithelial ovarian cancer. Rec ently it has been shown that liver cirrhosis is associated with increased l evels of CA 125, particularly in the presence of ascites. The aim of this s tudy was to evaluate CA 125 as a marker for the detection of ascites in pat ients with chronic liver disease. METHODS: A total of 170 patients were studied. All had ultrasound scanning for detection of ascites. Group I consisted of 123 patients with chronic li ver disease without ascites; whereas group II consisted of 47 patients with chronic liver disease with ascites. CA 125 levels were measured in all pat ients and also simultaneously in the ascitic fluid of 31 patients from grou p II. RESULTS: Of 47 patients, 46 (97.8%) of group II had elevated serum levels o f CA 125 (mean 321 +/- 283 U/ml) as compared with only nine of 123 (7.3%) p atients of group I [mean 13 +/- 15 U/ml]), p < 0.001. The mean CA 125 conce ntration in the ascitic fluid of 31 cirrhotic patients (group II) was 624 /- 397 U/ml and was always higher than corresponding serum levels (p < 0.01 ). Serum CA 125 levels correlated with the amount of ascitic fluid (r = 0.7 8). A profound decrease in serum CA 125 concentration was noted 2-3 and 10 days after large volume paracentesis. CA 125 was more sensitive and precede d ultrasonography in detection of ascites in few cirrhotic patients. CONCLUSIONS: CA 125 is a highly sensitive marker to detect ascites in patie nts with liver cirrhosis. This marker may be useful to detect small to mode rate amounts of ascitic fluid in cirrhotic patients when physical examinati on is difficult or equivocal for ascites. (Am J Gastroenterol 1999;94: 1613 -1618. (C) 1999 by Am. Cell. of Gastroenterology).