The Role of CA-125 in Differential Diagnosis of Ascites

ABS TRACT Objective: CA-125 has been found to be high in almost all the patients with ascites. In this study, we tried to determine cut-off values of CA-125 in serum and ascitic fluid levels in order to discriminate non-ovarian malignancies, ovarian carcinomas and benign diseases. Material and Methods: A total of 119 patients were included in the study. The patients were divided into three groups: non-ovarian malignancies, ovarian carcinoma and benign diseases. Serum and ascitic fluid CA-125 levels were measured by electrochemiluminescence immunoassay, ‘ECLIA’ method. In determining the discriminitive ability of CA-125 levels between the groups, receiver operating characteristic (ROC) analysis was performed. Results: A total of 119 patients were included in the study: 55 males and 64 females. Of patients, 53 had non-ovarian malignancy, 19 had ovarian car cinoma and 47 had benign diseases. Serum and ascitic fluid CA-125 levels were high in all of the three groups. When cut-off value of ascitic CA-125 was taken as 174 U/mL, the sensitivity and specificity were found to be 69.2% and 25.5%, respectively; however, when the value was ac cepted as 796.5 U/mL, these rates were observed as 30.8% and 80.9% respectively. In the dis crimination between ovarian carcinoma and benign diseases, when the cut-off value of ascitic CA-125 was considered as 411 U/mL, the sensitivity and specificity were obtained as 94.7% and 63.8% respectively. When the value was taken as 971.9 U/mL, the sensitivity and specificity rates were 57.9% and 78.7% respectively. Conclusion: In discriminating between malign and benign ascites, ascitic CA–125 levels rather than serum values are of significance, and it can be suggested that malignancy should be persistently searched when the value is over 1000 U/mL.