Tumor Necrosis Factor-α–Related Intraperitoneal Release of CA 125 in Cirrhotic Patients with Sterile Ascites

Cancer antigen 125 (CA 125) (1)(2)(3) is commonly increased in liver cirrhosis and increased even more in ascitic fluid(4)(5)(6). Peritoneal mesothelial cells can synthesize CA 125(7), and proliferative mesothelial cells stain for it(8). It is not clear whether mechanical stress related to ascites can stimulate mesothelium to produce CA 125(4)(6) or whether clearance of CA 125 by the diseased liver is impaired(4)(5). Mesothelial cells may regulate intraperitoneal antibacterial defense mechanisms(9)(10)(11). Cultured mesothelial cells produce cytokines, including interleukin-6 (IL-6) and IL-8, on stimulation with tumor necrosis factor-α (TNF-α) or IL-1β(9). Human peritoneal macrophages produce TNF-α and IL-1β after incubation with bacteria, which in turn can trigger mesothelial cells to produce IL-8(10) and IL-6(12). High serum concentrations of TNF-α and IL-6, possibly of intraabdominal origin, have been observed in cirrhotic patients with sterile ascites(13). We investigated whether the intraperitoneal release of CA 125 in cirrhotic patients with sterile ascites could be influenced by the stimulation of mesothelial cells with proinflammatory cytokines, such as TNF-α. We studied 72 consecutive …