Ovarian cancer is also known as the “silent killer”. When symptoms of ovarian cancer are suspected, blood tests and imaging tests can be performed. CA125 values are often used as indicators for blood tests. However, CA125 cannot be used as a screening test for ovarian cancer. inspection tool. However, once it is found to be ovarian cancer, CA125 plays an important role in tracking following surgery and treatment.
What is CA125? Tong Baoling, Director of the Department of Obstetrics and Gynecology at Hsinchu Branch of National Taiwan University Hospital, pointed out that CA125 (cancer antigen 125) is a glycoprotein secreted on the mucosal wall of the abdominal cavity. When the mucosa is inflamed, the value of CA125 will increase.
Not just ovarian cancer, CA125 values are raised in many cases. For example, Dr. Tong Baoling, such as pelvic inflammatory disease, menstrual period, appendicitis, ectopic pregnancy, pregnancy, liver cirrhosis, uterine fibroids, etc., will increase the value of CA125.
In addition to CA125, HE4 (human epididymis protein 4) is another indicator for ovarian cancer screening. The US FDA stated in 2008 that HE4 can be used as a tool for ovarian cancer screening. Compared with CA125, HE4 is less affected by endometriosis, such as chocolate cysts. However, due to the high price of HE4 index detection, CA125 is still the most common clinical application at present.
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CA125 Difficult to Screen for Early Ovarian Cancer
Dr. Tong Baoling reminded that if people meet the risk factors of ovarian cancer or have a family history of ovarian cancer, it is recommended to take a blood test to test the CA125 value. However, she pointed out that “most ovarian cancers are already in the third stage when they are discovered. Some literature points out that If CA125 detection is performed at the first stage of ovarian cancer, only one quarter of the patients will have elevated CA125 index, therefore, most of the first stage ovarian cancer cannot be detected by CA125 detection.”
In order to increase the screening rate of ovarian cancer, in addition to blood testing, ultrasound is a useful tool. Observe whether the shape of the ovaries is abnormal through pelvic or vaginal ultrasound, but there is no need to worry too much when the ultrasound detects abnormalities in the ovaries.
Dr. Tong Baoling shared that clinically, it is often seen that menopausal patients have hydroma on the ovaries during ultrasound, but CA125 is normal. This kind of situation is generally not a serious problem, so don’t worry too much.
CA125 plays an important role in ovarian cancer postoperative tracking
And if ovarian tumors are found at childbearing age, usually 90% of them are functional ovarian tumors, which will occur when ovulation is not good. However, functional ovarian tumors disappear on their own within three months. The remaining 10% of ovarian tumors may be chocolate cysts and teratomas, and cancer accounts for only a small part.
As for the standard value of CA125, generally the normal value of CA125 should be less than 35 U/ml. However, ovulation stops during menopause, so there is no possibility of functional ovarian cancer, and the CA125 value standard can be set at 20 U/ml. However, Director Tong Baoling emphasized that CA-125 cannot be used as an absolute cancer indicator. The greatest value of CA125 application is that it plays an important role in ovarian cancer postoperative and post-treatment tracking!
She pointed out that when treating ovarian cancer, the change of CA125 index can be used to evaluate the effect of chemotherapy and determine whether there is a possibility of recurrence. Ovarian cancer is prone to relapse, so it is recommended to follow up every three months, early detection of signs of recurrence can seize the time for treatment.
Interview with experts:Tong Baoling, Director of the Department of Obstetrics and Gynecology at Hsinchu Branch of National Taiwan University Hospital
Text/Li Zhihan Photo/Yang Shaochu
Further reading:
Symptoms are like gastroenteritis! The Silent Female Killer “Ovarian Cancer”
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