Spitzer M, Kaushal N, Benjamin F
Department of Obstetrics and Gynecology, Queens Hospital Center, Jamaica, NY 11432, USA.
J Reprod Med. 1998 Apr;43(4):387-92.
To determine the levels of CA-125 throughout pregnancy and the puerperium to establish a baseline, thereby indicating what values may be indicative of the pathologic conditions usually associated with elevated CA-125 levels.
A prospective, longitudinal study was carried out on a consecutive series of pregnant women to determine their CA-125 levels throughout pregnancy and during the puerperium. Blood was drawn at four- to six-week intervals for clinically indicated tests. The residual sera were kept frozen, and subsequently CA-125 measurements were determined by radioimmunoassay.
Of 34 women enrolled in the study, 20 completed the evaluations throughout pregnancy and in the puerperium. The remaining 14 had evaluations for varying portions of their pregnancies but not throughout pregnancy or during the puerperium. The results in these two groups were compared and found not to be statistically significantly different. For the group as a whole, the levels of CA-125 were high, with wide fluctuations in the first trimester; the levels in the early first trimester (five to eight weeks) were particularly high, with a mean of 55.8 and median of 36.2 (range, 6.9-251.2) U/mL. The levels then dropped and remained < 35 U/mL through the rest of pregnancy (including immediately prior to delivery). Another peak, with wide fluctuations, occurred soon after delivery, with a mean of 39.8 and median of 41.9 (range, 10.7-296.7) U/mL. In the late postpartum period (2-10 weeks after delivery) there was a return to baseline levels in all subjects.
This study showed that there is a distinct pattern in CA-125 levels during pregnancy and the puerperium. Due to the wide fluctuations in CA-125 levels in very early pregnancy and the immediate postpartum period, CA-125 values during these periods are not useful for clinical correlation with the pathologic conditions known to be associated with elevated levels of CA-125. However, further study is needed to determine whether extreme values in the first trimester or elevated levels after the first trimester are diagnostic or predictive of any conditions related to pregnancy.
测定整个孕期及产褥期的CA - 125水平以建立基线，从而明确哪些数值可能提示通常与CA - 125水平升高相关的病理状况。
对一系列连续的孕妇进行前瞻性纵向研究，以测定她们在整个孕期及产褥期的CA - 125水平。每隔四至六周采集血液进行临床指征检查。剩余血清冷冻保存，随后通过放射免疫测定法测定CA - 125水平。
本研究纳入的34名女性中，20名完成了整个孕期及产褥期的评估。其余14名对孕期不同阶段进行了评估，但未完成整个孕期或产褥期的评估。比较这两组结果，发现无统计学显著差异。总体而言，CA - 125水平较高，在孕早期波动较大；孕早期早期（五至八周）水平尤其高，均值为55.8，中位数为36.2（范围6.9 - 251.2）U/mL。随后水平下降，在孕期其余时间（包括临产前）保持<35 U/mL。产后不久出现另一个峰值，波动较大，均值为39.8，中位数为41.9（范围10.7 - 296.7）U/mL。在产后晚期（产后2 - 10周），所有受试者的水平均恢复至基线水平。
本研究表明孕期及产褥期CA - 125水平存在明显模式。由于孕早期极早期及产后即刻CA - 125水平波动较大，这些时期的CA - 125值对于与已知CA - 125水平升高相关的病理状况进行临床关联并无用处。然而，需要进一步研究以确定孕早期的极端值或孕早期后升高的水平是否对与妊娠相关的任何状况具有诊断或预测价值。
