Cancer Antigen 125 Levels Research Articles

The haunting diagnosis of malignancy in women with treatable reproductive system tuberculosis

This study reports a case of female genital tuberculosis in a 46-year-old woman who presented to emergency department with abdominal pain and progressive abdominal distension. The patient was initially thought to have ovarian cancer based on clinical diagnosis and elevated cancer antigen-125 (CA-125) levels. Intra-operatively, no obvious ovarian tumor was encountered instead; disseminated creamy white patches on the uterus and left adnexa were seen. About 4500-mL straw-colored ascitic fluid and disseminated creamy white patches were also found on the bowels and omentum giving an impression of carcinomatosis. However, histopathology of the fallopian tube and ovary confirmed the diagnosis of female genital tuberculosis as the underlying cause. Female genital tuberculosis often mimics tumors in its clinical appearance and symptoms, leading to misdiagnosis and unnecessary treatment. The key to diagnosing female genital tuberculosis is being suspicious as it is challenging to diagnose through laboratory tests or radiology. The mainstay of treatment for female genital tuberculosis is a combination of four antituberculosis drugs. Consideration of female genital tuberculosis as a differential diagnosis in women presenting with symptoms mimicking reproductive tumors is highly recommended as highlighted in this case report.

Impact of administering umbilical cord-derived mesenchymal stem cells to cynomolgus monkeys with endometriosis.

This study aimed to explore whether umbilical cord-derived mesenchymal stem cells (UC-MSCs) could be used as a therapeutic resource for endometriosis. Of seven cynomolgus monkeys with endometriosis, five were administered UC-MSCs (intervention group) and two were administered saline (control group). First, intravenous US-MSC treatment was administered for three months. Second, weekly intravenous US-MSC administration combined with monthly intraperitoneal US-MSC administration was conducted for 3 months. Finally, weekly intraperitoneal US-MSC administration was conducted for 3 months. The dose of UC-MSCs was set to 2 × 106 cells/kg for all administration routes. Laparoscopic findings and serum cancer antigen 125 (CA125) levels were also evaluated. The Revised American Society for Reproductive Medicine classification was used for laparoscopic evaluation. Laparoscopic findings showed exacerbation of endometriosis after intraperitoneal UC-MSC administration, although no changes were observed in the control group. Intravenous UC-MSC administration decreased the level of CA125 in all monkeys; however, the difference was not significant. Intraperitoneal UC-MSC administration significantly exacerbated endometriosis compared with intravenous administration (p = 0.02). This study revealed that intraperitoneal UC-MSC administration exacerbates endometriosis in a nonhuman primate model of the disease.

Predictive Value of Serum YKL-40, Interleukin-37, and Cancer Antigen 125 Panel in Noninvasive Staging of Endometriosis

Abstract Background: The diagnosis of advanced endometriosis remains challenging with considerable limitations in the diagnosis of retroperitoneal and deep infiltrating lesions. Thus, a well-defined panel of inexpensive, noninvasive inflammatory biomarkers could be a crucial tool for appropriate staging for women with suspected endometriosis. The aim of this work is to explore the potential use of serum YKL-40, interleukin-37 (IL-37), and cancer antigen 125 (CA125) for noninvasive staging of endometriosis patients for proper intervention and most optimal management of the condition. Methods: This study was conducted on 90 women, who had undergone laparoscopic or laparotomy surgery due to suspected pelvic endometriosis. Blood samples for serum YKL-40, IL-37, and CA125 levels assay were taken from all participants at admission for laparoscopy or laparotomy. After histopathological confirmation of the diagnosis, the selected cases were immunostained for YKL-40, IL-37, and CA125. Results: YKL-40, IL-37, and CA125 serum levels were significantly elevated in patients with endometriosis than healthy controls. Moreover, the association between the serum level and immunoexpression and grading of endometriosis. A triple combination panel of serum YKL-40, IL-37, and CA125 was found to have the best sensitivity and specificity (96.67% and 100.0%, respectively) compared to any single serum marker alone or double combination panel in predicting the severity of endometriosis. Conclusions: A triple combination panel of serum YKL-40, IL-37, and CA125 could be used in the future for predicting endometriosis stage, providing a practical reference for making better-informed decisions on the best treatment plan.

Exploring the landscape of CA-125 testing: A comprehensive analysis of Ministry of Health data.

The aim of this study was to investigate the utilization patterns and clinical implications of cancer antigen 125 (CA-125) testing in the diagnosis of ovarian and endometrial cancers using a large-scale dataset obtained from the Ministry of Health. A retrospective analysis was conducted on anonymized data collected between 2017 and 2021, comprising 3.917.240 individuals who underwent CA-125 testing. The data included demographic information, test results, diagnoses, and clinical characteristics. Descriptive statistics and comparative analyses were performed to assess the utilization trends and clinical outcomes associated with CA-125 testing. Among the study population, CA-125 testing was primarily requested for female individuals, with the highest number of tests performed in the age group of 18-64 years. The overall positive rate for CA-125 was 13.31%, with slightly lower rates observed in females (13.18%) than males (14.07%). The study identified a significant association between elevated CA-125 levels and cancer diagnoses, with 19.88% of positive CA-125 results indicating cancer, whereas 10.51% had no cancer diagnosis. Furthermore, the study revealed a higher likelihood of cancer detection among individuals aged 65 years and above, with a positive rate of 17.79%. Our findings provide valuable insights into the utilization patterns and clinical implications of CA-125 testing in ovarian and endometrial cancer diagnosis. While CA-125 remains a prominent tumor marker, its interpretation should consider age, gender, and clinical context. The study emphasizes the potential benefits of integrating additional markers and imaging modalities to enhance diagnostic accuracy. These findings contribute to optimizing the use of CA-125 testing for early detection and management of gynecological malignancies, thereby improving patient outcomes.

Risk of malignancy index: a useful tool in primary evaluation of ovarian masses at tertiary care center in Pakistan

<p>Background and Objective: The discrimination between benign and malignant adnexal masses is important for clinical management and surgical planning in such patients. The risk of malignancy index (RMI) is a combined parameter that is a simple, highly sensitive, and more specific scoring system based on three factors: serum cancer antigen 125 (CA-125) levels, ultrasonographic (USG) score, and menopausal status. The objective of the study is to evaluate the diagnostic efficacy of RMI for the primary evaluation of ovarian masses in females presenting at a local tertiary care hospital in Pakistan.</p>
 <p>Methods: This prospective observational study was carried out at the Gynecology outdoor clinic of Fouji Foundation Hospital, Rawalpindi, Pakistan. The study comprised 141 females admitted for surgical exploration of ovarian masses. Pre-operative USG evaluations of ovarian mass, menopausal status, and serum CA-125 levels were determined for all the patients. RMI was calculated and post-operative histopathology of resected ovarian masses was done in all the cases to confirm the diagnosis.</p>
 <p>Results: The sensitivity and specificity of CA-125 alone at a cut-off value of 35 U/ml was 67.64% and 83.17% respectively. Using a cutoff value for RMI at 200 U/ml, the specificity and sensitivity of CA-125 were 85.98% and 76.47%, respectively. The receiver operating characteristic curve revealed that RMI was a better discriminate than CA-125, ultrasound, and menopausal status alone.</p>
 <p>Conclusion: The RMI is a useful tool in the primary evaluation of ovarian masses. It can be used to differentiate between benign and malignant ovarian masses with high sensitivity and specificity. Suspected malignant patients can be referred to a gynecological oncologist for further management.</p>

Evaluation of single and combination chemotherapy agents in patients with metastatic breast cancer

Background: There are several ways to treat breast cancer, one of which is administering chemotherapy agents. Chemotherapy agents have activity in inhibiting the cell cycle. That will affect the effectiveness of therapy and the side effects of chemotherapy agents. Objective: This study aimed to evaluate single and combination chemotherapy agent therapeutic efficacy and side effects Method: The design of this study used an observational cohort study with retrospective data collection from January to December 2019. Patients obtained from medical records were diagnosed with metastatic stage of breast cancer at Panti Nirmala Hospital, Malang. The effectiveness of the chemotherapy agent was seen from the carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3), which were carried out in the first and third cycles, then analyzed using the Wilcoxon and U-Mann Whitney tests. Side effects of chemotherapy agents were analyzed descriptively. Results: Analysis of the Wilcoxon test showed differences between the two groups of chemotherapeutic agents in CEA and CA15-3 (p<0.05). U-Mann Whitney test analysis showed no difference after administration of the two groups of chemotherapy agents at CEA (p>0.05). However, there was a difference in CA15-3 (p<0.05). Both chemotherapy agents showed most common side effects such as pain, nausea, vomiting, and alopecia. Conclusion: Patients who received a combination of chemotherapy agents had lower CA15-3 levels than single chemotherapy agents.

Polypoid Endometriosis, a Benign Tumor with Perplexing Radiologic Features: A Case Report

Polypoid endometriosis is a rare form of endometriosis. It is a benign variant but its radiologic findings trick clinicians into concern about the tumor being malignant. A 42-year-old patient with a history of dysmenorrhea and adenomyosis presented a 60 mm-sized mass in the Douglas pouch with irregular echogenicity. The patient went under the first surgery for tumor removal, and its histopathologic diagnosis was endometriosis. We started daily dienogest medication to suppress tumor recurrence, but after 10 months we decided to stop the medication due to the side effects. Four months after the cessation, a new tumor recurred and after few months of observation, we performed the second surgery of tumor removal and total hysterectomy because of adenomyosis. The tumor was located in the retroperitoneal space in the Douglas pouch with severe adhesions. After the second surgery, the tumor marker Cancer antigen-125 level was normalized and the histopathologic result was endometriosis, which we concluded as polypoid endometriosis.

Evaluation of Serum Hormones and Biochemical Tumor Markers among Breast Cancer Patients in the South-South Region, Nigeria

Breast cancer remains one of the most frequent malignancies in women and the primary cause of cancer-related death in women all over the world. Hormones and tumor biomarkers have been implicated as possible causes and prognostic biomarkers of breast cancer. The present study investigated the use of serum hormonal levels and tumor biomarkers; Carcinoembrvonic antigen (CEA), and cancer antigen (CA 15-3) for the diagnosis of Breast Cancer, and generation of different subtypes using Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). This study is a cross-sectional study comprising 120 subjects; sixty breast cancer patients, and sixty apparently healthy women who served as control. One hundred and twenty blood samples were collected and analyzed for estrogen, progesterone, Carcinoembrvonic antigen, and cancer antigen. The results showed that the peak age of incidence of breast cancer was 40-49 years. Majority (56.7%) of the cases were menopausal women, while 43.3% were in their premenopausal period. Serum estrogen, cancer antigen, and Carcinoembrvonic antigen concentrations were elevated significantly (p<0.05) in the breast cancer patients than the control group. Premenopausal patients have higher progesterone, estradiol, Carcinoembrvonic antigen, and cancer antigen levels than those during the postmenopausal period. HER2 negative subtype (50.0%) is the most prevalent subtype of breast cancer. 8.4% were triple negative (ER–/PR–/HER2–) cases, while 1.7% were triple positive (ER+/PR+/HER2+) cases. Breast cancer is strongly associated with hormonal changes especially estrogen and progesterone during the premenopausal and postmenopausal periods in women. Thus, the determination of the concentration of estrogen, progesterone, Carcinoembrvonic antigen, cancer antigen, and human epidermal growth factor receptor 2 statuses could help in the prognosis of breast cancer.

The Potential Role of MUC16 (CA125) Biomarker in Lung Cancer: A Magic Biomarker but with Adversity.

Lung cancer is the second most commonly diagnosed cancer in the world. In terms of the diagnosis of lung cancer, combination carcinoembryonic antigen (CEA) and cancer antigen 125 (CA125) detection had higher sensitivity, specificity, and diagnostic odds ratios than CEA detection alone. Most individuals with elevated serum CA125 levels had lung cancer that was either in stage 3 or stage 4. Serum CA125 levels were similarly elevated in lung cancer patients who also had pleural effusions or ascites. Furthermore, there is strong evidence that human lung cancer produces CA125 in vitro, which suggests that other clinical illnesses outside of ovarian cancer could also be responsible for the rise of CA125. MUC16 (CA125) is a natural killer cell inhibitor. As a screening test for lung and ovarian cancer diagnosis and prognosis in the early stages, CA125 has been widely used as a marker in three different clinical settings. MUC16 mRNA levels in lung cancer are increased regardless of gender. As well, increased expression of mutated MUC16 enhances lung cancer cells proliferation and growth. Additionally, the CA125 serum level is thought to be a key indicator for lung cancer metastasis to the liver. Further, CA125 could be a useful biomarker in other cancer types diagnoses like ovarian, breast, and pancreatic cancers. One of the important limitations of CA125 as a first step in such a screening technique is that up to 20% of ovarian tumors lack antigen expression. Each of the 10 possible serum markers was expressed in 29-100% of ovarian tumors with minimal or no CA125 expression. Therefore, there is a controversy regarding CA125 in the diagnosis and prognosis of lung cancer and other cancer types. In this state, preclinical and clinical studies are warranted to elucidate the clinical benefit of CA125 in the diagnosis and prognosis of lung cancer.

Efficacy of dienogest versus gonadotropin-releasing hormone agonist combined with dienogest sequential therapy in the treatment of adenomyosis

Objective: To investigate the efficacy and safety of dienogest (DNG) alone and gonadotropin-releasing hormone agonist (GnRH-a) combined with DNG sequential treatment to adenomyosis. Methods: The clinical data of 110 patients with adenomyosis attending the First Affiliated Hospital of Nanjing Medical University from December 2019 to March 2022 were retrospectively analyzed, including 40 patients treated with DNG (2 mg/day) alone (DNG group) and 70 patients treated with sequential DNG (2 mg/day) after 3-6 injections of GnRH-a (GnRH-a+DNG group). The clinical data before and after treatment were compared between the two groups. Results: (1) The dysmenorrhea visual analogue scale (VAS) scores, cancer antigen 125 (CA125) and cancer antigen 19-9 (CA19-9) levels at different time periods after treatment were significantly lower than before treatment in both groups (median before treatment: DNG group 70.0 mm, 68.55 kU/L, 22.45 kU/L respectively, GnRH-a+DNG group 80.0 mm, 151.50 kU/L, 20.44 kU/L respectively; all P<0.001). (2) The hemoglobin (Hb) levels of patients in both groups at different time periods after treatment were significantly higher than those before treatment (median: DNG group 102.00 g/L, GnRH-a+DNG group 94.00 g/L; all P<0.001). (3) Treatment with DNG alone did not have a significant effect on uterine volume in patients of DNG group (P>0.05), and uterine volume decreased significantly in the 15th-24th months of GnRH-a+DNG group compared with that before treatment (median: 167.76 vs 227.77 cm3; P<0.05). (4) There were no significant differences in hepatic and renal function and coagulation indexes between the two groups before and after treatment (all P>0.05), and no significant abnormal lesions were observed in breast tissue during the follow-up period. (5) The incidence of amenorrhea of GnRH-a+DNG group was higher than that of DNG group, and the incidences of irregular spotting bleeding and breakthrough hemorrhage were lower than those in DNG group. Conclusions: Whether DNG is used alone or in combination with GnRH-a in sequence, it could significantly relieve dysmenorrhea symptoms, improve the level of Hb, reduce the levels of CA125 and CA19-9 in patients with adenomyosis, with no adverse effects on coagulation and hepatic or renal function. GnRH-a sequential DNG therapy is superior to DNG alone in improving uterine bleeding patterns and controlling the growth of uterine volume in patients with adenomyosis.

CA125 as a predictor of endometrial cancer lymphovascular space invasion and lymph node metastasis for risk stratification in the preoperative setting

Endometrial cancer (EC) is the most common malignancy of the female reproductive system. Cancer antigen 125 (CA125) is a serum tumor marker widely reported in EC patients, particularly those with poor prognostic factors such as grade 3 tumors, deep myometrial invasion, lymph node metastasis (LNM), and extra-uterine disease. This retrospective study stratifies pre-operative CA125 levels to evaluate odds ratios (OR) and relative risk (RR) between CA125 levels and the likelihood of +LNM, lymphovascular space invasion (LVSI), grade, and stage. Patient charts for women 18 years or older with a diagnosis of EC and pre-operative or within one week CA125 measurement from January 2000 to January 2015 at a regional hospital were reviewed. OR and RR were determined by unconditional maximum likelihood estimation for CA125 levels as the predictor with staging, grade, +LVSI and +LNM as outcomes. The largest increase in risk for patients having stage I/II/III disease was 52% greater (1.52-fold risk) while largest increase in risk for patients having stage III/IV disease was 67% greater (1.67-fold risk), both at CA125 ≥ 222U/ml. Patients with CA125 ≥ 122U/ml had significantly increased risk of +LNM, with maximum increase in risk of 98% (1.98-fold risk) at 222U/ml. Patients with CA125 ≥ 175U/ml had significantly increased risk of +LVSI, with maximum increase in risk of 39% (1.39-fold risk) at 222U/ml. This study shows that elevated CA125 levels correspond to increased stage, +LVSI, and +LNM in patients with EC.

Preoperative serum CA125 level and age at diagnosis: An effective prognosis prediction tool for patients with early-stage endometrial cancer.

To investigate the combined predictive value of the preoperative serum cancer antigen 125 (CA125) level and age at diagnosis among patients with early-stage endometrial cancer (EC) after initial treatment. We retrospectively analyzed data from patients with early-stage EC from 1999 to 2015 in multiple institutions in China. All 447 patients received postoperative adjuvant radiotherapy for FIGO 2009 stage I and II EC with complete data on preoperative serum CA125 levels. All patients were divided into four groups according to the ESMO-ESGO-ESTRO risk classification. The predictive probability of 5-year overall survival (OS) and the sensitivity and specificity of CA125 and age were calculated. The median follow-up time was 59 months (3-201 months). The 5-year OS and disease-free survival rates were 94.4% and 89.1%. Multivariate analysis showed that the preoperative CA125 level and age at diagnosis were independent prognostic factors for 5-year OS. The area under the curve for CA125 combined with age at diagnosis for 5-year OS was .692, and the corresponding sensitivity and specificity were 68.2% and 68.2% (p < .002), which were significantly better than the corresponding values for CA125 or age alone. After all 447 patients were divided into four groups according to CA125 combined with age, the 5-year OS of the elderly and higher CA125 group was only 73.7%. Although preoperative CA125 had limited sensitivity in predicting the prognosis for early-stage EC after initial treatment, it remains a useful serum marker for risk assessment of early-stage EC. Combining CA125 with age may increase its predictive sensitivity.

Predictive model for the preoperative assessment and prognostic modeling of lymph node metastasis in endometrial cancer

Lymph node metastasis (LNM) is a well-established prognostic factor in endometrial cancer (EC). We aimed to construct a model that predicts LNM and prognosis using preoperative factors such as myometrial invasion (MI), enlarged lymph nodes (LNs), histological grade determined by endometrial biopsy, and serum cancer antigen 125 (CA125) level using two independent cohorts consisting of 254 EC patients. The area under the receiver operating characteristic curve (AUC) of the constructed model was 0.80 regardless of the machine learning techniques. Enlarged LNs and higher serum CA125 levels were more significant in patients with low-grade EC (LGEC) and LNM than in patients without LNM, whereas deep MI and higher CA125 levels were more significant in patients with high-grade EC (HGEC) and LNM than in patients without LNM. The predictive performance of LNM in the HGEC group was higher than that in the LGEC group (AUC = 0.84 and 0.75, respectively). Patients in the group without postoperative pathological LNM and positive LNM prediction had significantly worse relapse-free and overall survival than patients with negative LNM prediction (log-rank test, P < 0.01). This study showed that preoperative clinicopathological factors can predict LNM with high precision and detect patients with poor prognoses. Furthermore, clinicopathological factors associated with LNM were different between HGEC and LGEC patients.

Inflammatory Mediators (CA125, CRP) and Uric Acid in Association with Severity of Preeclampsia in North Kordofan State, Western Sudan

Introduction: Inflammatory mediators could be laboratory markers of preeclampsia, as the induction of an inflammatory process within the placenta may trigger the expression of cancer antigen 125(CA125), C-reactive protein (CRP) and uric acid (UA). Regarding the pathophysiology of pre-eclampsia, there is defective trophoblastic invasion of uteroplacental blood vessels that leads to placental ischemia, and induction of an inflammatory process within the placenta.&#x0D; Objective: To evaluate the association of serum levels of cancer antigen (CA125), C-reactive protein (CRP) and serum uric acid with the Severity of Preeclampsia.&#x0D; Materials and Methods: The study recruited 200 singleton Sudanese pregnant women. These participants were divided into two groups: control (n = 100) and cases (n = 100). The cases were further subdivided into; mild preeclampsia (n =46), and severe preeclampsia (n = 54). The study groups were well-matched in maternal age, gestational age and body mass index. Blood samples were taken for measurement of serum cancer antigen-CA125, uric acid and C - reactive protein using immune- assay and enzymatic automated chemical analysis.&#x0D; Results: The mean levels of cancer antigen-CA125 in mild and severe preeclampsia groups were; 21.94±5.08 (IU/ml) and 40.77±9.82 (IU/ml) respectively, which were significantly higher, (P&lt;0.001) in comparison with the control group (16.88±7.36 (IU/ml). The mean levels of C-reactive protein in mild and severe preeclampsia were; 15.17±5.35 (mg/L), 31.49±12.56 (mg/L) respectively. There was significant difference in their levels, compared to the control group (4.79±1.78 (mg/L), (P&lt;0.01). Also, the mean levels of uric acid in mild and severe cases were; 6.44±1.98 and 7.37±2.00 which was significantly higher, in comparison with the control (4.00±0.61); (P&lt;0.001). The level of uric acid also, showed significant difference within the case (severe and mild) group (P&lt;0.05). CA125, CRP and UA level‎s correlated positively with Mean Arterial blood pressure (MAP), (r&gt;0.7; P &lt; 0.001). ROC curve validate the utility of these biomarker for the detection of preeclampsia severity (AUC&gt;0. 8; P &lt; 0.001).&#x0D; Conclusion: Serum cancer antigen 125(CA125), C- reactive protein and uric acid in studied preeclampsia groups were found to be significantly higher compared with the control group, and the rises were directly associated with the severity of preeclampsia.

Malignant Transformation of the Mature Cystic Teratoma of the Ovary

The mature cystic teratoma of ovary is most prevalent type of neoplasm of ovarian germ cells. It accounts for the almost 20% of the neoplasm. Objective: To find the malignant transformation of mature cystic teratoma of ovary. Methods: The study was conducted on the 28 patients who visited Cheikh Zayed Hospital Mauritania for the duration of six months from July 2018 to December 2018 and patients who underwent surgery related to ovarian cancer. All the patients underwent tumor marker tests to see the level of cancer antigen in their serum. The level of serum SCC antigen was also tested in all patients before carrying out any surgery. The level of CA-19-9 was also measured. CEA level to check the carcinoembryonic antigen was also carried out. Results: Among these 28, there were 15 patients that had malignant transformation from MCT. The age of patients was ranging from 28 to 74 years. The median age was 50 years. There were 9 patients that were on a post-menopausal state. There were 4 patients that were reported as nulliparous, the remaining were parous. Almost all the patients were presented with symptoms like lower abdominal pain and feeling of palpable mass in the lower abdomen. Conclusions: Malignant transformation in case of MCT is rare but it has poor prognosis. Its quick detection and proper treatment is very important. The use of surgical operation along with adjuvant treatment and chemotherapy have role in controlling the malignancy

Clinical efficacy of myometrial and endometrial microwave ablation in the treatment of patients with adenomyosis who had anemia

Objective This study evaluated the clinical efficacy of myometrial and endometrial microwave ablation (MEWA) for treating adenomyosis in patients with anemia. Methods This retrospective study enrolled 64 patients with adenomyosis who had anemia treated with either MEWA (MEWA group) or myometrial microwave ablation (MMWA group) between May 2019 and May 2021. The uterine volumes, uterine-volume reduction rates, hemoglobin (Hb) levels, cancer antigen 125 (CA125) levels, dysmenorrhea visual analog scale (VAS) scores, uterine fibroblast symptoms and health-related quality of life (UFS-QOL) scores, menstrual flow scores (MFS) before and 3, 6, and 12 months post-treatment, and adverse events and complications in both groups were collected to assess clinical efficacy. Results No statistically significant preoperative differences were observed in any measured factors. Postoperatively, there was a significant reduction in uterine volume and CA125 level, an increase in Hb level, and improvement in the UFS-QOL, dysmenorrhea VAS score, and MFS. No differences were observed in postoperative uterine volume, CA125 level, overall response rate, and adverse event rate during the follow-up period until 12 months postoperatively. However, the MEWA group showed a better uterine-volume reduction rate 6 months postoperatively and improvement in Hb level, USF-QOL score, dysmenorrhea VAS score, and MFS postoperatively. Conclusion MEWA and MMWA demonstrated high clinical efficacy in treating adenomyosis and anemia. However, MEWA is a more effective therapy that successfully improves anemia, resulting in improved quality of life.

Association of Cancer Antigen 125 with Long-Term Prognosis in Light-Chain Cardiorenal Amyloidosis

Introduction: Light-chain (AL) cardiorenal amyloidosis has been characterized as type 5 cardiorenal syndrome with fluid overload and poor prognosis. Cancer antigen 125 (CA125) has the potential for its use in evaluating fluid load and prognosis for heart failure. However, less details for CA125 in AL cardiorenal amyloidosis have been reported. Methods: Sixty patients diagnosed with AL cardiorenal amyloidosis were enrolled in this retrospective study. Patients were divided into two groups according to the cutoff point of CA125 level (35 U/mL). Logistic regression was used to screen variables associated with CA125. Cox regression analyses were utilized to verify the prognostic potential of CA125. Results: The mean age was 61 ± 8 years, and 68% of the participants were male. Compared to patients with normal CA125 levels (≤35 U/mL), patients with high levels of CA125 (>35 U/mL) had a higher proportion of New York Heart Association class >II, pericardial effusion, and edema, as well as a lower level of albumin and left ventricular longitudinal strain (LVLS). Logistic regression showed age, albumin, and LVLS to be independently associated with CA125. Seventeen (28%) patients died during the follow-up. Multivariate model including CA125, estimated glomerular filtration rate, E/e’, and left ventricular ejection fraction showed acceptable prognostic potential (C-index = 0.829, 95% CI: 0.749–0.909). CA125 remained an independent prognostic factor (HR = 1.018, 95% CI: 1.005–1.031, p = 0.008, per 10 U/mL increase) after adjusting for the remaining three variates and provided a significant incremental effect to the risk determined from them (C-index 0.829 vs. 0.784, p = 0.037). Conclusion: Serum CA125 level was associated with long-term prognosis of AL cardiorenal amyloidosis.

Activation of SH2 domain-containing protein tyrosine phosphatase and inflammatory expression in psoriasis

Psoriasis is a chronic autoimmune disease characterized by abnormal proliferation and differentiation of keratinocytes and infiltration of inflammatory cells into the site of inflammation. Plaque psoriasis is the most common type of psoriasis, affecting up to 80–90% of psoriasis cases. Among inflammatory cells, myeloid dendritic cells or Langerhans cells are mainly activated cells during the pathogenesis of psoriasis to induce activation and differentiation of naive T cells into T helper cells (Th)1 and Th17 cells. SH2 domain-containing protein tyrosine phosphatase (SHP) is a negative regulator of the phosphorylation of several proteins involved in cellular differentiation, growth and activation. Chronic inflammation promotes tumor progression, which is characterized by the release of carcinogenic antigens, including alpha-fetoprotein (AFP) and cancer antigen 125 (CA125) into blood and urine. They are common tumor markers to serve as predictors of cancer development and survival of cancer patients. To this end, blood samples of 103 psoriasis patients and 46 healthy subjects were collected. The mRNA expressions of SHP1 and SHP2 were examined by using quantitative RT-PCR and the serum levels of IL-6, TNF-α, IFN-γ, IL-17A, AFP and CA125 by ELISA. As a result, the mRNA level of SHP1 was higher expressed, whereas the level of SHP2 was unaltered in the patient group compared to the control individuals. Importantly, psoriasis patients had CA125 level higher than the clinical cutoff 35U/mL was 15.6%, while healthy individuals had CA125 level lower than 35U/mL. In addition, the serum TNF-α and IL-17A concentrations were significantly increased in the patient group. In conclusion, the results indicated the significant differences in expression of SHP1 gene and inflammatory response in psoriasis patients. This study further hint for investigations on the functional role of SHP1 in regulating activation of immune cells present in psoriasis patients.

Performance of the IOTA ADNEX model combined with HE4 for identifying early-stage ovarian cancer

ObjectiveThis work was designed to investigate the performance of the International Ovarian Tumor Analysis (IOTA) ADNEX (Assessment of Different NEoplasias in the adneXa) model combined with human epithelial protein 4 (HE4) for early ovarian cancer (OC) detection.MethodsA total of 376 women who were hospitalized and operated on in Women and Children’s Hospital of Chongqing Medical University were selected. Ultrasonographic images, cancer antigen-125 (CA 125) levels, and HE4 levels were obtained. All cases were analyzed and the histopathological diagnosis serves as the reference standard. Based on the IOTA ADNEX model post-processing software, the risk prediction value was calculated. We analyzed receiver operating characteristic curves to determine whether the IOTA ADNEX model alone or combined with HE4 provided better diagnostic accuracy.ResultsThe area under the curve (AUC) of the ADNEX model alone or combined with HE4 in predicting benign and malignant ovarian tumors was 0.914 (95% CI, 0.881–0.941) and 0.916 (95% CI, 0.883–0.942), respectively. With the cutoff risk of 10%, the ADNEX model had a sensitivity of 0.93 (95% CI, 0.87–0.97) and a specificity of 0.73 (95% CI, 0.67–0.78), while combined with HE4, it had a sensitivity of 0.90 (95% CI, 0.84–0.95) and a specificity of 0.81 (95% CI, 0.76–0.86). The IOTA ADNEX model combined with HE4 was better at improving the accuracy of the differential diagnosis between different OCs than the IOTA ADNEX model alone. A significant difference was found in separating borderline masses from Stage II–IV OC (p = 0.0257).ConclusionsA combination of the IOTA ADNEX model and HE4 can improve the specificity of diagnosis of ovarian benign and malignant tumors and increase the sensitivity and effectiveness of the differential diagnosis of Stage II–IV OC and borderline tumors.

The role of some inflammatory markers, cytokins and tumor markers in diagnosis of endometriosis

Endometriosis is a multifactorial disease which etiopathogenesis has not been elucidated. One of the theories of etiopathogenesis is the inflammatory theory. Aims of the study: To develop a practical non-invasive test for the diagnosis of endometriosis by examining some inflammatory markers and cytokines; to compare the highly sensitive C-reactive protein (hsCRP), cytokines (interleukin-6-IL-6 and tumor necrotizing factor alpha) and the tumor marker cancer antigen 125 (CA-125) among healthy patients and patients with endometriosis; to determine the sensitivity and specificity of each biomarker separately in the diagnosis of endometriosis and to determine their role in the diagnosis of endometriosis. Materials and methods: In a prospective study conducted at the University Clinic for Gynecology and Obstetrics, Ss. Cyril and Methodius University in Skopje, North Macedonia 138 patients were included of a reproductive age between 18-50 years (83 with diagnosis endometriosis operated laparoscopically or with laparotomy) and a control group of 55 healthy women, in a period between 01.09.2018 to 01.05.2021. Serum levels of IL-6, TNF-α, hs-CRP and tumor marker CA-125 were evaluated in both groups. Results: Serum levels of CA-125, IL-6 and TNF-α and hs-CRP were significantly higher in patients with endometriosis compared to the control group. The surface under the ROC curve (AUC) for IL-6, CA-125, hs-CRP, and TNF-α has shown that as individual markers they all have a discriminatory capacity to diagnose patients with endometriosis. Conclusions: Results obtained in our study showed statistically significantly higher serum concentrations of CA-125, IL-6 and TNF-α and hs-CRP in patients with endometriosis compared to the control group of patients. However, none of these biomarkers showed a high sensitivity for diagnosis of endometriosis. It is necessary to find a panel combination of biomarkers with a high sensitivity of about 100% that will enable early diagnosis of endometriosis.