Cancer Antigen 125 (CA-125) is a glycoprotein biomarker & used in the medical field for the detection and management of ovarian cancer, also known as the carbohydrate antigen 125. CA-125 is a cell surface glycoprotein which is found in higher concentrations in the blood of women having ovarian cancer. Its applications extend beyond cancer detection, as its levels can also be elevated in various non-cancerous conditions.
Clinical Uses of CA-125
- Ovarian Cancer Detection:
- Screening and Diagnosis:
- Monitoring Treatment and Recurrence:
- Non-Ovarian Cancers:
- Elevated CA-125 levels are not exclusive to ovarian cancer. They also observed in other malignancies, e.g., fallopian tube, endometrial, pancreatic, breast, and other colorectal cancers. In these cases, CA-125 is used more as a secondary marker for assessing the extent of disease or treatment effectiveness.
- Non-Cancerous Conditions:
- Endometriosis:
- Pelvic Inflammatory Disease (PID):
- Fibroids:
- Menstruation:
- Pregnancy
- Â Liver diseases
- Kidney disease
- Risk Assessment and Prognosis:
Diagnosis Markers and Tests used for Cancer Antigen 125 (CA-125)
- HE4 (Human Epididymis Protein 4):
- Transvaginal Ultrasound (TVUS):
- CT Scans and MRIs
- Future Directions and Research
- Blood Test (Serum CA-125 Test)
- Pelvic Examination
- Biopsy
- Genetic Testing (e.g., BRCA1 and BRCA2)
Limitations of CA-125 Testing
- False Positives: Many non-cancerous conditions can cause elevated CA-125 levels, potentially leading to false positives. For example, menstruation, pregnancy, and other benign gynecological conditions can all raise CA-125 levels.
- False Negatives: Not all ovarian cancers produce elevated CA-125 levels, particularly in early-stage disease, which limits the sensitivity of this test. For example, in women with early-stage ovarian cancer or those with non-epithelial ovarian cancers, CA-125 levels may not be significantly raised.
- Lack of Specificity: CA-125 levels are most often associated with ovarian cancer, but other malignancies and various benign conditions can also elevate CA-125. This lack of specificity means CA-125 should not be used in isolation to diagnose cancer or assess treatment effectiveness without considering other clinical factors and imaging tests.
Conclusion
It aids in the management of ovarian cancer detection and monitoring purposes. It is an essential part of clinical practice. The constraints in sensitivity and specificity require careful understanding in interpretation ,in combination with other diagnostic tools and clinical factors. It also results in enhanced cancer care by providing more accurate, non-invasive, and personalized treatment options.