Serum CA-125: biomarker of pulmonary tuberculosis activity and evaluation of response to treatment

Purpose: CA-125 is a high molecular weight mucin-like glycoprotein and an ovarian cancer antigen. Elevated CA-125 levels are also seen with various other benign and malignant conditions. In this study, the ability of CA-125 to predict pulmonary tuberculosis activity was investigated. Methods: This analytical study included 42 cases with active tuberculosis (Group 1), 35 cases with inactive tuberculosis (Group 2) and 20 healthy subjects (Group 3). CA-125 measurements were taken in all three groups. Measurements in Group 1 were repeated after completing a two month anti-tuberculosis treatment in 38 of the 42 patients. Results: Mean serum CA-125 level for Group 1 was 76.48 +/- 24.71 U/mL, which was significantly higher than levels in Group 2 (20.01 +/- 7.89 U/mL) and Group 3 (18.32 +/- 2.87 U/mL) (p<0.001).. Of the 38 patients in Group 1 who were studied both pre- and post-treatment, CA-125 levels decreased significantly: from 78.88 +/- 24.72 U/mL before treatment to 22.78 +/- 8.02 U/mL after treatment (p<0.001). There was no statistically significant difference between the post-treatment values of Group 1 and either Group 2 and Group 3 values (p>0.05). Group 2 and Group 3 levels were not significantly different (p>0.05). The cut-offlevel for accurate determination of activity was 36.35 U/mL. The sensitivity at this level was 97.6% and specificity was 100%. Conclusion: Our findings suggest that CA-125 can be a beneficial parameter in determination of pulmonary tuberculosis activity and the evaluation of response to treatment.