metricas
covid
Buscar en
Clínica e Investigación en Ginecología y Obstetricia
Toda la web
Inicio Clínica e Investigación en Ginecología y Obstetricia Variabilidad de las concentraciones séricas de CA 125 en mujeres sanas en funci...
Información de la revista
Vol. 33. Núm. 4.
Páginas 122-129 (agosto 2006)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 33. Núm. 4.
Páginas 122-129 (agosto 2006)
Originales
Acceso a texto completo
Variabilidad de las concentraciones séricas de CA 125 en mujeres sanas en función de la edad, situación hormonal y otras condiciones
Visitas
1488
B. Barceló, A. Barceló, M. Riesco, G. Pérez, B. Castanyer, M. Vila
Servicio de Análisis Clínicos. Hospital Universitario Son Dureta. Palma de Mallorca. España
Este artículo ha recibido
Información del artículo
Resumen

Los conocimientos relativos a los factores que influyen en las concentraciones de CA 125 ha conducido a cuestionarse la validez de un único valor límite. Los objetivos del trabajo fueron valorar los valores de CA 125 en función de la edad, presencia o ausencia de menopausia, índice de masa corporal (IMC), hábito tabáquico, paridad, variabilidad durante el ciclo menstrual, variabilidad biológica, índice de individualidad y diferencia crítica. Se incluyó a 65 mujeres sanas distribuidas en 2 grupos: sin y con menopausia. Los principales resultados demuestran que existe una clara relación entre las concentraciones de CA 125 y la edad, que en mujeres sin menopausia la concentración de CA 125 fue superior respecto a las mujeres con menopausia, con p95 de 30,52 y 18,30 U/ml, respectivamente. No encontramos variaciones durante el ciclo menstrual, aunque existe la probabilidad de encontrar valores superiores al valor límite convencional durante la fase folicular. La variabilidad biológica intra e interindividual en mujeres sin menopausia fue del 14,23 y el 43,57%, respectivamente, mientras que la variabilidad biológica interindividual en mujeres con menopausia fue del 36,25%. La diferencia crítica fue del 42,73% y el índice de individualidad de 0,11. No encontramos diferencias en función de la paridad ni del hábito tabáquico. Tampoco encontramos una relación respecto al IMC.

En conclusión, el conocimiento de factores que influyen en las concentraciones séricas de CA 125, así como la adaptación de valor límite en función de diferentes situaciones fisiológicas y clínicas puede permitir una mejor interpretación e identificación de subgrupos con un riesgo de presentar cáncer de ovario.

Abstract

Knowledge of the factors influencing serum concentrations of CA 125 have led the validity of a single cut-off value to be questioned. The aims of the present study were to evaluate CA 125 levels according to age, menopause, body mass index (BMI), smoking, parity, variability during the menstrual cycle, biological variation, index of individuality (II), and critical difference (CD). Sixty-five healthy women distributed in 2 groups, non-menopausal and menopausal, were included.

The main results of the study demonstrate that there is a clear relationship between CA 125 levels and age: serum levels of CA 125 were significantly lower in menopausal women than in non-menopausal women, with 95th percentiles of 30.52 U/ml and 18.30 U/ml, respectively. No variations were found during the menstrual cycle, although a CA 125 value higher than the conventional cut-off value was observed during the follicular phase. In non-menopausal women, intra- and interindividual biological variations were 14.23% and 43.57%, while in menopausal women interindividual biological variation was 36.25%. CD was 42.73% and II was 0.11. No significant differences were found between smokers and nonsmokers or according to parity. No relationship was found between CA 125 levels and BMI.

In conclusion, knowledge of the factors influencing serum concentrations of CA 125 according to different physiologic and clinical factors and careful adjustment of cut-off values could improve interpretation and identification of subgroups at risk for ovarian carcinoma.

El Texto completo está disponible en PDF
Bibliografía
[1.]
R.C. Bast, M. Feeney, H. Lazarus, L.M. Nadler, R.B. Colvin, R.C. Knapp.
Reactivity of a monoclonal antibody with human ovarian carcinoma.
J Clin Invest, 68 (1981), pp. 1331-1337
[2.]
I. Dilek, H. Ayakta, C. Demir, C. Meral, M. Ozturk.
CA 125 levels in patients with non-Hodgkin lymphoma and other hematologic malignancies.
Clin Lab Haematol, 27 (2005), pp. 51-55
[3.]
H. Nagele, M. Bahlo, R. Klapdor, D. Schaeperkoetter, W. Rodiger.
CA 125 and its relation to cardiac function.
Am Heart J, 137 (1999), pp. 1044-1049
[4.]
H.A. Fritsche, R.C. Bast.
CA 125 in ovarian cancer: advances and controversy.
Clin Chem, 44 (1998), pp. 1379-1380
[5.]
J.R. Van Nagell, P.D. DePriest.
Manegement of adnexal masses in postmenopausal women.
Am J Obstet Gynecol, 193 (2005), pp. 30-35
[6.]
R.C. Bast Jr, T.L. Klug, E. St John, E. Jenison, J.M. Niloff, H. Lazarus, et al.
A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer.
N Engl J Med, 309 (1983), pp. 883-887
[7.]
E.M. Davelaar, G.J. van Kamp, R.A. Verstraeten, P. Kenemans.
Comparison of seven immunoassays for the quantification of CA 125 antigen in serum.
Clin Chem, 44 (1998), pp. 1417-1422
[8.]
N.P. Koper, C.M.G. Thomas, L.F.A.G. Massuger, M.J. Van der Mooren, L.A.L.M. Kiemeney, A.L.M. Verbeek.
Serum CA 125 concentrations in women of different ages, hormonal statuses, or clinical conditions.
Int J Gynecol Cancer, 7 (1997), pp. 405-411
[9.]
D.K. Pauler, U. Menon, M. McIntosh, H.L. Symecko, S.J. Skates, I.J. Jacobs.
Factors influencing serum CA125II levels in healthy postmenopausal women.
Cancer Epidemiol Biomarkers Prev, 10 (2001), pp. 489-493
[10.]
J.O. Westgard.
Internal quality control: planning and implementation strategies.
Ann Clin Biochem, 40 (2003), pp. 593-611
[11.]
H.E. Van Ingen, D.W. Chan, W. Hubl, H. Miyachi, R. Molina, L. Pitzel, et al.
Analytical and clinical evaluation of an electrochemiluminiscence immunoassay for the determination of CA 125.
Clin Chem, 44 (1998), pp. 2530-2536
[12.]
J.M.G. Bonfrer, C.M. Korse, R.A. Verstraeten, G.J. van Kamp, G.A.M. Hart, P. Kenemans.
Clinical evaluation of the Byk LIA-mat CA-125 II assay: discussion of a reference value.
Clin Chem, 43 (1997), pp. 491-497
[13.]
S.J. Skates, F.J. Xu, Y.H. Yu, K. Sjovall, N. Einhorn, Y. Chang, et al.
Toward an optimal algorithm for ovarian cancer screening with longitudinal tumor markers.
Cancer, 76 (1995), pp. 2004-2010
[14.]
V.R. Zurawski, K. Sjovall, D.A. Schoenfeld, S.F. Broderick, P. Hall, R.C. Bast, et al.
Prospective evaluation of serum CA 125 levels in a normal population, phase 1: the specificities of single and serial determinations in testing for ovarian cancer.
Gynecol Oncol, 36 (1990), pp. 299-305
[15.]
E.M. Davelaar, E.M.J. Schutter, S. Von Mensdorff-Pouilly, G.J. Van Kamp, R.A. Verstraeten, P. Kenemans.
Clinical and technical evaluation of the ACS:OV serum assay and com–parison with three other CA 125 detecting assays.
Ann Clin Biochem, 40 (2003), pp. 663-673
[16.]
T. Suriyama, T. Nishida, K. Komai, H. Nishimura, M. Yakushyi, H. Nishiymusa.
Comparison of Ca 125 assays with abdominopelvic computed tomography and transvaginal ultrasound in monitorin ovarian cancer.
Int J Gyn Obstet, 54 (1996), pp. 2151-2156
[17.]
T. Alagoz, R.E. Buller, M. Berman, B. Anderson, A. Manetta, P. DiSaia.
What is a normal CA125 level?.
Gynecol Oncol, 53 (1994), pp. 93-97
[18.]
M.H. Vuento, U.H. Stenman, J.P. Pirhonen, J.I. Makinen, P.J. Laippala, T.A. Salmi.
Significanced of a single CA 125 assay combinated with ultrasound in the early detection of ovarian and endometrial cancer.
Gynecol Oncol, 64 (1997), pp. 141-146
[19.]
G.G. Bon, P. Kenemans, J.J. Dekker, P.G. Hompes, R.A. Verstraeten, G.J. Van Kamp, et al.
Fluctuations in CA 125 and CA 15-3 serum concentrations during spontaneous ovulatory cycles.
Human Reproduction, 14 (1999), pp. 566-570
[20.]
G.G. Bon, P. Kenemans, R. Verstraeten, G.J. Van Kamp, J. Hilgers.
Serum tumor markers immunoassays in gynecologic oncology: Establishment of reference values.
Am J Obstet Gynecol, 174 (1996), pp. 107-114
[21.]
S.S. Im, A.N. Gordon, B.M. Buttin, C.A. Leath, B.S. Gostout, C. Shah, et al.
Validation of referral guidelines for women with pelvic masses.
Obstet Gynecol, 105 (2005), pp. 35-41
[22.]
ACOG Committee Opinion The role of the generalist obstetrician- gynecologist in the early detection of ovarian cancer Obstet Gynecol 100 (2002), 1413-1416.
[23.]
E.E. Calle, C. Rodriguez, K. Walker-Thurmond, M.J. Thun.
Overweight, Obesity, and Mortality from Cancer in a Prospectively Studied Cohort of U.S. Adults.
N Engl J Med, 348 (2003), pp. 1625-1638
[24.]
A.B. Erbagci, N. Yilmaz, I. Kutlar.
Menstrual cycle dependent variability for serum tumor markers CEA, AFP, CA 19-9, CA 125 and CA 15-3 in healthy women.
Dis Markers, 15 (1999), pp. 259-267
[25.]
P.J. Green, S.K. Ballas, P. Westkacper, H.G. Schwartz, T.L. Klug, V.R. Zurawski.
CA 19-9 and CA125 levels in the sera of normal blood donors in relation to smoking history.
J Natl Cancer Inst (Bethesda), 77 (1986), pp. 337-341
[26.]
Y. Haga, K. Sakamoto, H. Egami, R. Yoshimura, M. Akagi.
Evaluation of serum CA125 values in healthy individuals and pregnant women.
Am J Med Sci, 292 (1986), pp. 25-29
[27.]
W. Mastropaolo, Z. Fernández, E.L. Miller.
Pronounced increases in the concentration of an ovarian tumor marker, CA-125, in serum of a healthy subject during menstruation.
Clin Chem, 32 (1986), pp. 2110-2111
[28.]
M.D. Hornstein, P.P. Thomas, R.E. Gleason, R.L. Barbieri.
Menstrual cyclicity of CA-125 in patients with endometriosis.
Fertil Steril, 58 (1992), pp. 279-283
[29.]
D.E. Pittaway, J.A. Fayes.
Serum CA 125 antigen concentrations increases during menses.
Am J Obstet Gynecol, 156 (1987), pp. 75-76
[30.]
P. Hompes, P. Koninckx, S. Kennedy, et al.
Serum CA 125 concentrations during midfollicular phase, a clinically useful and reproducible marker in diagnosis of advanced endometriosis.
Clin Chem, 42 (1996), pp. 1871-1874
[31.]
A. O¿Shaughnessy, J.H. Check, K. Nowroozi, D. Lurie.
CA 125 levels measured in different phases of the menstrual cycle in screening for endometriosis.
Obstet Gynecol, 81 (1993), pp. 99-103
[32.]
M.C.K. Browning, N.P. McFarlane.
Objetive interpretation of results for tumor markers.
J Nucl Med Allied Sci, 34 (1990), pp. 89-91
[33.]
M.K. Tuxen, G. Soletormos, P.H. Petersen, V. Schioler, P. Dombernowsky.
Assessment of biological variation and analytical imprecision of CA 125, CEA, and TPA in relation to monitoring of ovarian cancer.
Gynecol Oncol, 74 (1999), pp. 12-22
[34.]
M.K. Tuxen, G. Soletormos, G.J. Rustin, A.E. Nelstrop, P. Dombernowsky.
Biological variation and analytical imprecision of CA 125 in patients with ovarian cancer.
Scand J Clin Lab Invest, 60 (2000), pp. 713-721
Copyright © 2006. Elsevier España S.L.. Todos los derechos reservados
Descargar PDF
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos