CA 125 (cont.)
What is the normal range for CA 125?
The normal values for CA 125 may vary slightly among individual laboratories.
In most laboratories, the normal value is less than 35 U /ml.
What does an elevated CA 125 mean, and how is the test used?
It is not possible to interpret the meaning of an abnormally high CA 125
without additional information about the particular patient being evaluated. The
reason is that blood levels of this protein can be increased in many different benign and
malignant conditions. The two most frequent situations in which CA 125 is used
is to monitor patients with a known
cancer (malignancy) or as one of several
tests in the workup of a patient suspected of having a tumor.
The most common use of the test is the monitoring of women with known cancer
of the ovary (ovarian cancer). In the patient who is known to have a malignancy,
such as ovarian cancer, the CA 125 level can be monitored periodically. A
decreasing level generally indicates that therapy, including chemotherapy, has
been effective, while an increasing level indicates tumor recurrence. Because of
test variation, small changes are usually not considered significant. A doubling
or halving of the previous value would be important.
In the patient who is being evaluated for a pelvic mass, a CA 125 level
greater than 65 is associated with malignancy in approximately 90% of cases.
However, without a demonstrable mass, the association is much weaker.
What conditions other than ovarian cancer can cause an increased CA 125?
A number of benign conditions can cause elevations of the CA 125 level,
including pregnancy, endometriosis, uterine fibroids (benign tumors),
pancreatitis, normal menstruation,
pelvic inflammatory disease, and liver
disease. Benign tumors or cysts of the ovaries can also cause an abnormal test result.
Increases can also be seen in cancers other than ovarian cancer, including
malignancies of the uterine tubes, endometrium,
lung,
breast, pancreas, and
gastrointestinal tract.
Next: Is CA 125 testing useful as a cancer screening test? »
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