Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Sunday, 12 / 16 / 2018

Articles

CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study

ORIGINAL ARTICLE

CA-125 Significance in Cirrhosis and Correlation with Disease Severity and Portal Hypertension: A Retrospective Study

Raja GR Edula*,1, Sujit Muthukuru2, Serban Moroianu1, Yucai Wang1, Vivek Lingiah1, Phoenix Fung1 and Nikolaos T Pyrsopoulos1

1Division of Gastroenterology & Hepatology, Rutgers New Jersey Medical School, Newark, NJ, USA
2Fairview Hospital, Cleveland Clinic, Fairview Park, OH, USA

*Correspondence to: Raja GR Edula, Department of Gastroenterology & Hepatology, Rutgers New Jersey Medical School, 185 S Orange Avenue, MSB H-538, Newark, New Jersey 07103, USA. Tel: +1-973-972-5252, Fax: +1-973-972-3144, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2018;6(3):241-246 DOI: 10.14218/JCTH.2017.00070
Received: October 29, 2017 Accepted: March 22, 2018 Published online: July 2, 2018

Abstract

Background and Aims: To evaluate the prevalence and significance of elevated cancer antigen-125 (CA-125) levels in patients with cirrhosis being treated in a tertiary care liver center and its correlation with objective markers of disease severity.

Methods: We retrospectively reviewed medical records of 172 adult patients with cirrhosis (due to any etiology) after obtaining CA-125 serum analysis. Demographics, etiology of cirrhosis, model of end-stage liver disease (MELD) score, Child’s Turcotte-Pugh classification, albumin bilirubin (ALBI) score, degree of ascites, presence of esophageal varices, serum CA-125 level and various other parameters were collected. Statistical analysis was performed using SPSS software and descriptive statistics.

Results: Elevated CA-125 levels were noted in 147 patients (85%) of the study population. Higher MELD score was associated with higher CA-125 levels (p = 0.001). Statistically significant correlation was observed between elevated CA-125 levels and degree of ascites (p < 0.001), ALBI score (p < 0.001) and Child’s Turcotte-Pugh class (p < 0.001). No correlation was observed with presence or absence of esophageal varices. Near-normal CA-125 levels were noted in patients with cirrhosis but undetectable ascites on ultrasound imaging. No differences were observed in mean values between male and female patients (p = 0.207). Regression analysis confirmed that CA-125 levels had a better correlation with degree of ascites than MELD score or ALBI score.

Conclusions: Elevated CA-125 levels were noted in 85% of patients with cirrhosis at our center. Our study establishes that the more advanced the degree of decompensation based on MELD score, Child’s Turcotte-Pugh classification and ALBI score, the higher the elevation in CA-125. Absence of ascites was associated with normal CA-125 level, with a direct correlation between high levels and worsening ascites, but there was no statistically significant correlation with esophageal varices, indicating that elevated CA-125 levels could be related to mechanical stretch of the peritoneum rather than portal hypertension itself. Further multi-centered studies are required to confirm and validate these findings.

Keywords

Portal hypertension, Ascites, Esophageal varices, MELD score, Child’s Turcotte-Pugh classification

 

 

 

Journal of Clinical and Translational Hepatology 2018 vol. 6, 241-246  [ Html ] [ PDF Full-text ]

 

© The Authors 2018. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

 

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