CA-125 in benign and malignant diseases involving coelomic epithelium

The presence of CA-125 (cut-off 35 U/ml) was assessed in serum from 263 neoplastic and 65 non neoplastic patients and in the pleural or ascitic fluid from 84 of them (49 neoplastic and 35 non neoplastic). Tumors (including mesotheliomas, mucinous and non-mucinous ovarian carcinomas, primitive and metastatic cancers of lung and liver and of the digestive tract) were staged according to TNM and FIGO classification and the tumors with peritoneal or pleural effusion considered apart. Non malignant patients had liver cirrhosis, lung inflammation and effusions due to heart failure. CA-125 was positive in most of the sera from patients with ovarian cancer and benign and malignant serous involvement; high concentrations were found in all examined effusions. The relationship between development of serous effusion and the increasing level of serum CA-125 could explain the abnormal serum concentrations found in diseases with peritoneal or pleural involvement. This could also explain the increased levels of CA-125 and ovarian carcinoma (including mucinous) progression which may extend resulting in peritoneal localization. Elevation of serum CA-125 may be expected in patients with all types of diseases affecting peritoneum and pleura and this marker may be used in the follow-up of epithelial ovarian carcinomas as well as of tumors involving coelomic epithelium