Abstract
Objective: To determine the association between serum CA-125 levels and degree of fibrosis in chronic liver disease with portal hypertension. Methodology: This study was conducted at Mayo Hospital Lahore. A total of 63 patients with liver cirrhosis were enrolled, demographic, clinical and laboratory parameters were documented. Modified FIB-4 index was calculated and value of 3 or more was defined as advanced liver cirrhosis. Receiver Operating Characteristic (ROC) curve was applied to calculate cut off value for CA-125 as 50 IU/L. Pearson correlation and linear regression analysis were applied to determine the association between CA-125 and modified fib -4 index. Results: Sixty three patients were enrolled. Mean age was 52.047±12.78. Female patients were 22(34.9%) and male patients were 41(65.1%). Regarding the clinical features, 8(12.7%) patients had jaundice, 38(60.3%) had ascites , 61(96.8%) had splenomegaly ,58(92.1%) had history of upper gastrointestinal bleed while 12(19%) had history of hepatic encephalopathy. Mean value of Modified fib-4score was 4.75±2.89SD, 43(67.2%) had value above cutoff of 3. Total of 38(60.3%) had CA-125 value above the cutoff level of 50 IU/L. CA-125 value above 50 IU/L has 63% sensitivity and 70% specificity in predicting advanced liver fibrosis and this association was statistically significant. (p value 0.024) . Conclusion: Serum CA-125 level above 50 IU/L is associated with presence of significant liver fibrosis.
Highlights
Chronic liver disease has high morbidity and mortality after progression to stage of decompensation
Five percent of Pakistani population suffers from hepatitis C and a lot of these patients develop progressive liver fibrosis[3]
Various markers have been studied to evaluate the clinical presentation of portal hypertension
Summary
Chronic liver disease has high morbidity and mortality after progression to stage of decompensation. It is one of the major contributors to chronic diseases worldwide. It accounts for 1.6% and 2.1% of the global burden regarding disability-adjusted life years and years of life lost respectively. Cirrhosis is the eleventh most common cause of death all over the world[1]. A study in Pakistan has established Hepatitis C as the commonest cause of chronic liver disease[2]. Five percent of Pakistani population suffers from hepatitis C and a lot of these patients develop progressive liver fibrosis[3]
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