Raised CA125 – what we actually know... TOG 2020

Question 1

Leading cause of death from gynae malignancy

Answer 1

Ovarian cancer
70% Dx stage III or IV

Question 2

Causes of raised CA125

Answer 2

Question 3

Relationship between CA125 & mechanical stress

Answer 3

CA125 raised if fluid inserisal spaces - peritoneal, pleural.

CAS125 released by mesothelial call in response to mechanical stretch produced by fluids.

Question 4

CA125 raised in which type of ovarian caner

Answer 4

Ovarian epithelial cancers

Question 5

What proportion of women with stage 1 disease will have a normal CA125

Answer 5

50%

Question 6

Following treatment what proportion of patients with a normal CA125 will have micro/macro disease

Answer 6

40%

Question 7

What proportion of advanced disease have raised CA125

Answer 7

75-90%

Question 8

When is peak CA125 in menstrual cycle?

Answer 8

During menstruation
Not seen in women undergone hysterectomy

Question 9

Is CA125 effected by pregnancy

Answer 9

Yes rises in 1st trimester, reduction in 2nd

Question 10

How is CA125 use in primary care

Answer 10

If symptoms of ovarian cancer request CA125, if >35 then order USS

Question 11

Red flag Sx for ovarian cancer?

Answer 11

Question 12

How can prememopausal cysts be risk strafed?

Answer 12

IOTA rules so CA125 not required

Question 13

Other potential ovarian tumour marker?

Answer 13

Human epididymis protein 4
78% sensitivity
Can be used in ROMA (risk of ovarian malignancy algorithm - uses CA125 & HE4)