CA 125, a new prognostic marker for aggressive NHL

الملخص EN

Purpose : CA 125 was evaluated in the sera of patients with aggressive NHL, together with LDH and ß2m, in a trial to assess its value in the diagnosis and follow-up, and to compare it to some prognostic factors.

Subjects and Methods : the study included 78 newly diagnosed patients with diffuse large B cell non-Hodgkin’s lymphoma (DLBCL), with age range 18-60 years, and a WHO performance status of 0, I or II, in addition to twenty apparently healthy controls.

All patients received CHOP regimen for 6 cycles Results : the levels of CA 125 and LDH were significantly higher in DLBCL compared to the control group (p-value = 0.031 and = 0.009, respectively).

Cutoff levels used were 20U / ml, 310 U / L, and 2mg / l for CA125, LDH and ß2m, respectively.

CA125 serum level was high in 55 %, LDH level in 72 %, and ß2m level in 62 % of patients.

As regards the stage, CA 125 was elevated in 17 %, 80 %, 25 %, and 100 % of patients in stage I, II, III, and IV, respectively.

CA 125 was elevated in 81.3 % of patients with bulky disease, in 83.3 % presenting with involvement of more than 1 extra nodal site, and in 90 % presenting with effusion.

The highest levels of CA125, LDH, and ß2m were observed in stage IV, and lowest in stage I (p-value < 0.001, 0.005, and 0.154, respectively).

There was also a significant positive correlation between CA 125 and LDH (p-value > 0.001).

CA 125 showed specificity of 80 % with 95 % CI (56, 94) and LDH showed sensitivity of 72 % with 95 % CI (81-60).

81-Complete response to treatment was achieved in 71.8 % of our patients.

Survival at 24 months was 78.2 %.

There was a statistically significant increase in survival in patients with CA125 < 20U / ml, patients with LDH < 310U / L, and patients with ß2m < 2mg / l (p-value = 0.006, 0.025, and 0.042, respectively).

A shorter disease-free survival was associated with increased CA 125 (p < 0.001).

Conclusion : CA125 was found to correlate with stage, tumor bulk, involvement of more than 1 extra nodal site, and presence of effusion.

Elevated levels of CA 125 and LDH were found to predict decreased survival.

Initial Measurement of CA125 may, therefore, provide valuable prognostic information.