Elevated serum CA-125 levels in hemodialysis patients with peritoneal, pleural, or pericardial fluids

Objective. Serum CA-125, an ovarian tumor marker, is used especially in the follow-up of ovarian cancer for monitoring the efficacy of therapy and for early detection of recurrence. A number of benign gynecologic as well as b enign and malignant nongynecologic conditions are associated with elevated serum CA-125 levels. Malignant and nonmalignant serosal fluids were also fo und to be associated with high serum levels of CA-125, suggesting that the presence of fluid in the serosal cavities may stimulate its release. Methods. We performed a clinical study in 39 patients (21 females, 18 males ) on chronic hemodialysis who were divided into two groups based on the pre sence of fluid in the serosal cavities (peritoneum, pleura, or pericardium) without clinical and radiologic evidence of neoplasia. There were 26 patie nts (16 females, 10 males) aged 50.11 +/- 13.86 years (range, 20-76 years) in the serosal fluid-negative group (group 1) and 13 patients (8 females, 5 males) aged 45.30 +/- 18.84 years (range, 17-73 years) in the serosal flui d-positive group (group 2). The control group consisted of 52 healthy volun teers (30 females, 22 males) aged 44.19 +/- 12.59 years (range, 19-68 years ). Results. Significantly elevated serum CA-125 levels were found in hemodialy sis patients with serosal fluid (P < 0.05) when compared with both the hemo dialysis patients without serosal fluid and the control group. There was no statistically significant difference between the control group and the pat ients without serosal fluids (P > 0.05). Conclusion. Although CA-125 can be considered a reliable tumor marker in pa tients undergoing hemodialysis, it should be interpreted with caution in pa tients with serosal fluids. (C) 2000 Academic Press.