Serum CA-125: biomarker of pulmonary tuberculosis activity and evaluation of response to treatment

Abstract

CA-125 is a high molecular weight mucin-like glycoprotein and an ovarian cancer antigen. Elevated CA-125 levels are also seen with various other benign and malignant conditions. In this study, the ability of CA-125 to predict pulmonary tuberculosis activity was investigated. This analytical study included 42 cases with active tuberculosis (Group 1), 35 cases with inactive tuberculosis (Group 2) and 20 healthy subjects (Group 3). CA-125 measurements were taken in all three groups. Measurements in Group 1 were repeated after completing a two month anti-tuberculosis treatment in 38 of the 42 patients. Mean serum CA-125 level for Group 1 was 76.48 ± 24.71 U/mL, which was significantly higher than levels in Group 2 (20.01 ± 7.89 U/mL) and Group 3 (18.32 ± 2.87 U/mL) (p < 0.001). Of the 38 patients in Group 1 who were studied both pre- and post-treatment, CA-125 levels decreased significantly: from 78.88 ± 24.72 U/mL before treatment to 22.78 ± 8.02 U/mL after treatment (p < 0.001). There was no statistically significant difference between the post-treatment values of Group 1 and either Group 2 and Group 3 values (p > 0.05). Group 2 and Group 3 levels were not significantly different (p > 0.05). The cut-off level for accurate determination of activity was 36.35 U/mL. The sensitivity at this level was 97.6% and specificity was 100%. Our findings suggest that CA-125 can be a beneficial parameter in determination of pulmonary tuberculosis activity and the evaluation of response to treatment.