Jeff Davies>>> Hugh Mitchell
<
[log in to unmask]> 05/21/03 05:02pm >>>
Dear
Colleagues
CA125 is probably one of the most non-specific markers in use - it
is
evelated in a whole variety of malignant and benign
intra-abdominal
conditions as well as involvements with peritoneum,
endometrium, liver -
it's almost an acute phase protein. It also varies with
the menstrual
cycle, which is why the Bart's study won't accept
pre-menopausal women.
However, as with all markers, a linear rise in log
concentration is pretty
well diagnostic of underlying malignancy -
particularly ovary. When the
CA125 rise is secondary to another primary, such
as breast or colon, the
rise is not, in our experience, linear.
For the
concerned patient who has had close relatives die from ovarian
cancer and
have insisted on CA125 measurements, we have recommended serial
levels. In a
number of cases, diagnoses have been made on the basis of
these linearly
rising markers, two of which were certainly pre-menopausal.
Hugh
Mitchell
Medical Oncology,
CXH
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