Cancer antigen 125 levels in serum can predict the recurrence of ascites in patients with cirrhosis of the liver.

The relationship between the risk of ascites recurrence and the level of cancer antigen 125 (CA 125) in serum was studied in two independent groups of patients with cirrhosis of the liver. The first group included 17 patients admitted to hospital due to ascites. When the episode was resolved, diuretic treatment was suspended and the CA 125 level in serum was determined. Eight patients had CA 125 levels above 35 U/ml (200.5 +/- 152.1 U/ml) when discharged from hospital, and ascites reappeared in all these cases within 30 days. The other nine cases (25.1 +/- 17.1 U/ml) remained free of ascites (p less than 0.005). In the second group, no evidence of ascites was found in 21 patients during 28 out-patient physical examinations. At the time of the examinations, abdominal echographic studies and CA 125 measurements were carried out. In 17 examinations, ascitic fluid was not detected by echography. CA 125 levels were normal (10.8 +/- 9.1 U/ml), and none of these subjects developed ascites. Echography detected peritoneal fluid during the remaining 11 examinations and CAH 125 levels in these cases were above 35 U/ml (278 +/- 276.9) (p less than 0.001). Six of these patients developed ascites within 30 days. We conclude that CA 125 levels can predict ascites recurrence in patients with cirrhosis of the liver.