15Jan 2020

HIGHER SERUM CA - 125 LEVELS CORRELATED WITH ADVANCING STAGING AND EXTRANODAL LESIONS IN EGYPTIAN NON - HODGKINS LYMPHOMA (NHL) PATIENTS

  • Internal Medicine Department, Faculty of Medicine, Benha University, Egypt.
  • Microbiology and Immunology Department, Faculty of Medicine, Benha University, Egypt.
  • Clinical Oncology Department, Faculty of Medicine, Zagazig University, Egypt.
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Serum CA-125 level has been shown to be elevated in patients with non-Hodgkins lymphomas (NHLs) and it is proposed that cytokines released by lymphoma cells activate mesothelial cells to secrete this glycoprotein. Aim of Study: The aim was to evaluate whether serum CA-125 levels vary with extranodal extension and disease staging of Egyptian NHL patients Patients and Methods: 117 adult patients with NHL were included, and based on the patients available laboratory (CBC, ESR, liver enzymes, LDH), radiological (CT scans and PET scanning), and pathological (reports of biopsies obtained from affected lesions) investigations, the sites of lesions (nodal and/or extranodal), disease staging (from stage I to IV), and performance status PS (from PS-0 to PS-5) were determined at patients presentation. Serum CA-125 levels were estimated for all studied patients. Results:Mean serum CA-125 level in all studied patients was 59.2?17.8 u/mL, with no significant differences between males and females. Patients with PS-3 had higher serum CA-125 levels than patients with PS-2 and PS-1. Serum CA-125 levels were significantly higher in patients presented with B symptoms (125.9?31.2 u/mL) compared to those with no B symptoms (57.2?18.7 u/mL). Serum CA-125 levels showed significant positive non-linear correlation with the disease stages, where the mean serum CA-125 levels in patients with stage-I NHL was 51.7?15.2 u/mL, stage-II was 61.3?17.6 u/mL, stage-III was 93.1?31.8 u/mL, and stage-IV was 167.1?59.6 u/mL.Mean serum CA-125 levels in patients with extranodal lesions only (217.1?47.9 u/mL) and in patients with both nodal and extranodal lesions (198.2?41.7 u/mL) were significantly higher compared to its levels in patients with nodal lesions only (51.7?16.3 u/mL). Conclusion and Recommendations: In NHL patients, the presence of B symptoms, advancing stages of disease, and extranodal lesions were associated with higher serum C-125 levels. Further studies are recommended to set a cut-off point for using serum CA-125 levels as an indicator for NHL extranodal lesions.

  1. Bairey O, Blickstein D, Stark P, Prokocimar M, Nativ H, Kirgner I and Shaklai M: Serum CA 125 as a prognostic factor in non-Hodgkins lymphoma. Leuk Lymphoma, 2003; 44(10); 1733-1738.
  2. Memar B, Aledavood A, Shahidsales S, Ahadi M, Farzadnia M, Raziee H, Noori S, Amouian S and Mohtashami S: The prognostic role tumor marker CA-125 in B-cell non-Hodgkins lymphoma. Iran J Cancer Prev., 2015; 8(1): 42-46.
  3. International Non-Hodgkins lymphoma Prognostic Factor Project: Apredictive model for aggressive non-Hodgkins lymphoma. N Engl J Med., 1993; 329: 987-994.
  4. Sanjeev G and Bela G: Evaluation of CA-125 as a prognostic marker in patients with non-Hodgkins lymphoma. Internal Journal of Medical and Health Research; 2017; volume 3; Issue 4; page 113-115.
  5. Fauzia A and AbdusSamad S: Association of serum CA-125 levels with non-Hodgkins lymphoma. Pak J Physiol, 2017; 13(1); 54-56.
  6. Rump A, Morikawa Y, Tanaka M, Minami S, Umesaki N, and Takeuchi M: Binding of ovarian cancer antigen CA125/MUC16 to mesothelin mediates cell adhesion. J BiolChem, 2004; 279; 9190-9198.
  7. Sanusi A, Zweers M, Weening J, de Waart DR, Struijk D and Krediet R: Expression of cancer antigen 125 by potential mesothelial cells is not influenced by duration or peritoneal dialysis. Perit Dial Int., 2001; 21(5); 495-500.
  8. Pui T and Ludwig C: CA-125 a tumor marker in NHL. J of Clinical Oncology, 1995; 13: 1827.
  9. Lazzarino M, Orlandi E, Klersy C, Astori C, Brusamolino E, and Corso A: Serum CA 125 is of clinical value in the staging and follow-up of patients with non-Hodgkins lymphoma: correlation with tumor parameters and disease activity. Cancer, 1998; 82: 576-582.
  10. Cheson B, Fisher R and Barrington S: Guideline recommendations for initial evaluation, staging, and response of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J ClinOncol, 2014; 32(27); 3059-3068.
  11. Oken M, Creech R, Tormey D, Horton J, Davis T, McFadden E, and Carbone P: Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J ClinOncol, 1982; 5; 649-655.
  12. Kubonishi I, Bandobashi K, and Miyoshi I: High serum levels of CA125 and IL-6 in patients with Ki-I lymphoma. Br J Hematol, 1997; 98; 452.
  13. Dawson-Saunders B and Trapp GT (editors): Basic and Clinical Biostatistics. Norwalk, Connecticut, Lange Medical Books, Appleton & Lange, 1994, page 123.
  14. Harris N, Jaffe E, Armitage J, and Shipp M: Lymphoma classification: from R.E.A.L. to WHO and beyond. Cancer: Principles and Practice of Oncology Updates; 1999; 13 (3): 1-14.
  15. Abdel Gawad I and Shafik M: CA-125, a New Prognostic Marker for Aggressive NHL. Journal of Egyptian Nat. Cancer Inst., 2009; vol. 21. No. 3, September 2009; 209-217.
  16. Jamal Z, Osamah H, Walid B, and Shmuel Z: Serum CA-125: A tumor marker for monitoring response to treatment and follow-up in patients with non-Hodgkins lymphoma. Oncologist, 2004; 9(4): 417-421.
  17. Abdelmonem A, Amany S, Maysa T, Saleh I, and Saadia I: Serum CA-125 as a diagnostic and prognostic in pediatric lymphoma. J Med Sci., 2007; 7(7): 1192-1196.
  18. Dilek I, Ayakta H, Demir C, Meral C, and Ozturk M: CA-125 levels in patients with non-Hodgkins lymphoma and other hematologic malignancies. Clin Lab Haematol., 2005; 27(1): 51-55.
  19. Prochazka V, Faber E, Raida L, Kapitanova Z, Langova K, Indark K, and Papajik T: High serum carbohydrate antigen-125 (CA-125) level predicts poor outcome in patients with follicular lymphoma independently of the FLIPI score. Int J Haematol., 2012; 96(1): 58-64.
  20. Lokanathan V, Gupta G, Ghalaut V, Ghalaut P, and Mahor A: CA-125 in non-Hodgkins lymphoma and its association with severity of the disease. Am MultidiscipInt Res J., 2015; 2(4): 1-6.

[Ali Hasaneen, Mohamed Ahmed, Reem R. Abdel-Galil and Abdel Motaleb Mohamed (2020); HIGHER SERUM CA - 125 LEVELS CORRELATED WITH ADVANCING STAGING AND EXTRANODAL LESIONS IN EGYPTIAN NON - HODGKINS LYMPHOMA (NHL) PATIENTS Int. J. of Adv. Res. 8 (Jan). 1183-1190] (ISSN 2320-5407). www.journalijar.com

Ali Hasaneen
Internal Medicine Department, Faculty of Medicine, Benha University, Egypt.

DOI:

Article DOI: 10.21474/IJAR01/10422      
DOI URL: https://dx.doi.org/10.21474/IJAR01/10422

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