Cancer antigen 125 in patients with chronic liver disease.

OBJECTIVES: To determine the association between elevated levels of serum cancer antigen (CA) 125 and liver disease and to explore the possibility that CA 125 is produced by the peritoneum as a nonspecific response to the presence of fluid in the peritoneal cavity.

PATIENTS AND METHODS: Between June and October 1992, CA 125 levels were measured in serum stored from 50 consecutive patients with cirrhotic ascites, 20 patients with cirrhosis but without ascites, and 12 patients with acute viral hepatitis without ascites. Serum CA 125 was also measured in 4 patients with chronic renal failure before and after initiation of continuous ambulatory peritoneal dialysis.

RESULTS: Levels of CA 125 were elevated in patients with all forms of liver disease, especially in those with cirrhotic ascites irrespective of the etiology of cirrhosis or the presence of spontaneous bacterial peritonitis or hepatocellular carcinoma. Levels of CA 125 did not change significantly 1 month after initiation of continuous ambulatory peritoneal dialysis.

CONCLUSION: Cancer antigen 125 is elevated in patients with acute and chronic liver disease, especially in those with cirrhotic ascites. This elevation in CA 125 is not because of a nonspecific response of the peritoneum to fluid in the peritoneal cavity. Awareness of the association of elevated CA 125 in patients with cirrhotic ascites can prevent unnecessary surgical intervention.