Bastani B, Chu N
Division of Nephrology, St. Louis University Health Sciences Center, Mo. 63110, USA.
Am J Nephrol. 1995;15(6):468-72. doi: 10.1159/000168888.
Serum Ca-125, an ovarian tumor marker, is used to screen and follow up patients with overian cancer. Normal values (< 35 U/ml) have been reported in patients with end-stage renal disease and patients maintained on chronic hemodialysis (HD). Non-malignant ascites has been associated with high serum levels of CA-125, suggesting that the presence of fluid in the peritoneal cavity may stimulate its release. We studied 38 HD and 43 chronic ambulatory peritoneal dialysis (CAPD) patients with regard to serum CA-125 levels. In the HD patients, the mean +/- SE serum CA-125 level was 10.1 +/- 1.7 U/ml (range < 5-39) with 8% of the patients having serum levels of > 35 U/ml. In the CAPD patients, the mean serum CA-125 level in all samples collected (n = 68) was 17.7 +/- 2.7 U/ml (range < 5-101, p < 0.01 vs. HD) with 16% of the sera showing levels of > 35 U/ml. The high serum CA-125 levels in the CAPD patients were from sera obtained within 2 months of diagnosis of peritonitis, peritoneal dialysis (PD) catheter implantation, or intra-abdominal surgery. When serum samples from this 2-month period were excluded, the mean serum CA-125 level was 8.9 +/- 1.5 U/ml (p = NS vs. HD) and only 1 patient had an abnormal level. Peritoneal dialysate CA-125 levels during an episode of peritonitis were significantly higher than at the baseline (69.1 +/- 14.2 vs. 21 +/- 2.5, p = 0.004) and both were significantly higher than the serum levels (p < 0.0001). Serum CA-125 levels were also the same in both sexes and races. In conclusion, it was found that while the serum CA-125 level is within normal limits in the majority of HD and stable CAPD patients, it is not uncommon that it is elevated in CAPD patients within 2 months of peritonitis, PD catheter placement, or intra-abdominal surgery, particularly when peritoneal exchanges are temporarily on hold in the latter two. The serum CA-125 level should be interpreted with caution in the CAPD patients as it may be a non-specific marker of peritoneal irritation. It was also found that there was a significant removal of CA-125 by the peritoneal fluid which markedly increased during episodes of peritonitis.
血清CA - 125是一种卵巢肿瘤标志物，用于筛查和随访卵巢癌患者。据报道，终末期肾病患者和维持性慢性血液透析（HD）患者的CA - 125值正常（<35 U/ml）。非恶性腹水与血清CA - 125高水平相关，提示腹腔内液体的存在可能刺激其释放。我们研究了38例血液透析患者和43例持续性非卧床腹膜透析（CAPD）患者的血清CA - 125水平。血液透析患者的平均±标准误血清CA - 125水平为10.1±1.7 U/ml（范围<5 - 39），8%的患者血清水平>35 U/ml。在CAPD患者中，所有采集样本（n = 68）的平均血清CA - 125水平为17.7±2.7 U/ml（范围<5 - 101，与血液透析组相比p<0.01），16%的血清水平>35 U/ml。CAPD患者血清CA - 125高水平来自腹膜炎诊断、腹膜透析（PD）导管植入或腹部手术诊断后2个月内采集的血清。排除这2个月期间的血清样本后，平均血清CA - 125水平为8.9±1.5 U/ml（与血液透析组相比p = 无显著性差异），只有1例患者水平异常。腹膜炎发作期间腹膜透析液中CA - 125水平显著高于基线水平（69.1±14.2对21±2.5，p = 0.004），且两者均显著高于血清水平（p<0.0001）。血清CA - 125水平在男女和不同种族中也相同。总之，研究发现，虽然大多数血液透析患者和稳定的腹膜透析患者血清CA - 125水平在正常范围内，但在腹膜炎、腹膜透析导管置入或腹部手术后2个月内，腹膜透析患者血清CA - 125水平升高并不少见，尤其是后两种情况腹膜交换暂时停止时。在腹膜透析患者中，血清CA - 125水平应谨慎解读，因为它可能是腹膜刺激的非特异性标志物。还发现腹膜液可显著清除CA - 125，在腹膜炎发作时清除量明显增加。
