Tumour Markers and Cirrhosis: The Ca-125 Who Came in From the Cold

118 ARTICLE SUMMARY Serum CA-125 is commonly used as a marker for ovarian cancer (1,2), although it can be elevated in nongynecological malignancy and benign gynecological disease (2). In this prospective study, serum CA-125 was measured preand postliver transplantation in 57 cirrhotic patients (67% men) as well as two patients with polycystic liver disease and abdominal distention without ascites. Ascitic CA-125 levels were determined in five patients who had paracentesis. Mesothelial CA125 staining was performed in 16 hepatectomy specimens. The mean serum CA-125 level pretransplant was 352±549 U/L (normal less than 37 U/L) and 46±49 U/L post-transplant (P<0.001). The mean ascitic CA-125 was 951±322 U/L compared with the mean serum level of 619±290 U/L (P<0.003). The CA-125 mesothelial staining grade was 0.8±1.4 and 1.5±1.1 in patients with normal and elevated serum CA-125 (P=0.37). The two patients with polycystic liver disease without ascites also had elevated CA-125. On multivariate analysis, ascites was the only predictive variable for elevated serum CA125.