Hugh
Thanks for this. With regard to the 'concerned patient'
- how long apart do you do the serial measurements?
- How many do you do?
- What do you regard as a significant rise?
- Is this valid even if results are in the totally 'normal' range
Cathryn
-----Original Message-----
From: Hugh Mitchell [mailto:[log in to unmask]]
Sent: 21 May 2003 17:03
To: [log in to unmask]
Subject: CA-125
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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