CA-125; a new marker for diagnosis and follow-up of patients with tuberculous peritonitis

Background. Most malignancies with peritoneal infiltration, especially ovar ian cancers and chronic liver diseases associated with ascites give rise to high serum CA-125 levels. Tuberculous peritonitis is another cause for hig h serum CA-125 levels. Aim. To investigate the relation between serum CA-125 level and response to treatment in tuberculous peritonitis patients. Patients. Ten patients with tuberculous peritonitis were enrolled in the st udy. Method. Definite diagnosis of tuberculous peritonitis was made by acid-fast smears, specific culture, and polymerase chain reaction. Serum CA-125 leve ls were measured before and at the fourth month of treatment. Results. Before antituberculous treatment, serum CA-125 levels of all patie nts were very high (mean+/-SD: 475.80+/-106. 19 U/ml) and comparable with t hose of patients with ovarian cancers. At the end of the fourth month of tr eatment, serum CA-125 levels in all patients decreased to within normal lim its (<35 U/ml)(20.80:+/-5.18 U/ml) in parallel with the clinical improvemen t. The differences in CA125 levels before and after treatment were statisti cally significant (p < 0.001). Conclusions. Results of our study suggest that serum CA-125 levels in patie nts with tuberculous peritonitis are as high as ovarian cancers associated with peritoneal infiltration. By the end of the fourth month of antitubercu lous therapy, serum CA-125 levels have returned to normal. We, therefore, s uggest that serum CA-125 can be used to evaluate the efficacy of therapy in tuberculous peritonitis.