CA-125 ve Over Kanseri Haricindeki Klinik Kullanımları
Synopsis
Although Cancer Antigen 125 (CA-125) is a tumor marker widely used in the prognosis of ovarian cancer, monitoring treatment efficacy, and detecting recurrences, elevated serum levels can also be observed in non-ovarian malignancies and benign conditions due to its low specificity. Encoded by the MUC16 gene, this glycoprotein is synthesized by mesothelial cells in response to mechanical stress, congestion, and stimulation by inflammatory cytokines such as TNF-α and IL-6. In acute and chronic heart failure, CA-125 serves as an important cardiac biomarker reflecting extravascular and interstitial fluid accumulation as well as the severity of congestion. Unlike natriuretic peptides, CA-125 levels are not affected by age, renal dysfunction, or body mass index, and show strong positive correlations with NYHA functional class, length of hospital stay, readmission, and mortality risk. Consequently, it plays a potential role in monitoring treatment response and decongestion. Serum and fluid CA-125 concentrations increase significantly in the presence of pleural, pericardial, and peritoneal effusions, as well as ascites. Particularly in liver cirrhosis accompanied by ascites, it is a more sensitive parameter than ultrasonography for the early detection of fluid accumulation. Additionally, elevated CA-125 levels can be encountered in lymphoma, nephrotic syndrome, peritonitis, tuberculosis, and following surgical interventions. In conclusion, when elevated serum CA-125 levels are detected in the presence of ascites, serosal effusions, and heart failure without a distinct pelvic tumor mass, clinicians should thoroughly evaluate them considering non-ovarian cardiac, serosal, and benign etiologies.
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