Lazzarino M, Orlandi E, Klersy C, Astori C, Brusamolino E, Corso A, Bellio L, Gargantini L, Morra E, Bernasconi C
Institute of Hematology, University of Pavia, Division of Hematology, IRCCS Policlinico San Matteo, Italy.
Cancer. 1998 Feb 1;82(3):576-82.
CA 125 is a glycoprotein produced by epithelial ovarian tumors and by mesothelial cells; its levels also have been shown to be elevated in patients with non-Hodgkin's lymphoma (NHL).
The authors evaluated serum CA 125 levels in patients with NHL to elucidate the frequency of this finding, its relationship with other presenting features, and its potential role as tumor marker. One hundred and fifty-seven patients underwent the first CA 125 assessment at onset, 54 at disease recurrence or progression, and 62 during complete remission (CR).
Of the 157 patients evaluated at diagnosis (median CA 125: 26 U/mL; range, 2-1400 U/mL), 63 (40%) had increased CA 125 values. Higher CA 125 levels were associated with advanced disease, aggressive histology, mediastinal and/or abdominal involvement, bulky tumor, high tumor burden, effusions, contiguous extranodal extension, high serum lactate dehydrogenase (LDH) activity, and elevated beta2-microglobulin (beta2-M) levels. Parameters identified by multivariate analysis to be independently associated with high CA 125 were: aggressive histology, mediastinal and/or abdominal disease, bulky tumor, high serum LDH activity and beta2-M serum levels, and the presence of effusion (P = 0.0000; explained variation = 0.64). Of the patients presenting with abnormal CA 125 levels, all those who achieved a CR (35) and 3 of the 6 who achieved a partial response had normalization of CA 125 values by the end of treatment. Conversely, CA 125 remained above normal values in 18 nonresponders. All 62 patients evaluated during CR showed normal CA 125 levels. Among patients first evaluated at disease recurrence or progression, 22 of 54 (41%) showed increased CA 125 levels, which were associated with the same parameters of disease found in patients examined at diagnosis.
High serum CA 125 levels were found to correlate with mediastinal and/or abdominal involvement, high tumor mass, and effusions, reflecting the reaction of mesothelial cells to the tumor. Serum CA 125 is a reliable biologic marker for the staging and restaging of patients with lymphoma. Serial measurements are useful, in conjunction with other markers, for monitoring response to treatment.
CA 125是一种由上皮性卵巢肿瘤和间皮细胞产生的糖蛋白；其水平在非霍奇金淋巴瘤（NHL）患者中也已显示升高。
作者评估了NHL患者的血清CA 125水平，以阐明这一发现的频率、其与其他临床表现的关系以及其作为肿瘤标志物的潜在作用。157例患者在发病时进行了首次CA 125评估，54例在疾病复发或进展时进行评估，62例在完全缓解（CR）期间进行评估。
在诊断时评估的157例患者中（CA 125中位数：26 U/mL；范围，2 - 1400 U/mL），63例（40%）CA 125值升高。较高的CA 125水平与疾病晚期、侵袭性组织学、纵隔和/或腹部受累、巨大肿瘤、高肿瘤负荷、积液、连续结外扩展、高血清乳酸脱氢酶（LDH）活性以及β2 - 微球蛋白（β2 - M）水平升高相关。多变量分析确定与高CA 125独立相关的参数为：侵袭性组织学、纵隔和/或腹部疾病、巨大肿瘤、高血清LDH活性和β2 - M血清水平以及积液的存在（P = 0.0000；解释变异 = 0.64）。在CA 125水平异常的患者中，所有达到CR的患者（35例）以及6例达到部分缓解的患者中的3例在治疗结束时CA 125值恢复正常。相反，18例无反应者的CA 125仍高于正常水平。在CR期间评估的所有62例患者CA 125水平均正常。在疾病复发或进展时首次评估的患者中，54例中的22例（41%）CA 125水平升高，这些升高与诊断时检查的患者中发现的相同疾病参数相关。
发现高血清CA 125水平与纵隔和/或腹部受累、高肿瘤块和积液相关，反映了间皮细胞对肿瘤的反应。血清CA 125是淋巴瘤患者分期和再分期的可靠生物学标志物。连续测量与其他标志物一起对于监测治疗反应是有用的。
