Aim of the work: study the levels of CA 125 in patients with B-cell non-hodgkin lymphoma and to evaluate its value as an index for the disease extent and response to treatment.
Methods: forty two patients,including 22 male paients (52.4%) and 20 females (47.6%,) including various age groups ranging from 19 to 65 years, with histological diagnosis of B cell NHLwere enrolled in this study whom were newly diagnozed and untreated. After documenting full medical history and clinical evaluation ,investigations including bone marrow biopsy, CT scans, baseline haematology and biochemistry were done. Serum CA-125 levels were measured at diagnosis and after completion of 6 cycles of CHOP chemotherapy regimen.
RESULTS: The studied patients including 35 patients (83.3%) with diffuse large B cell lymphoma , 5 patients (11.9%) with follicular lymphoma and 1 patient (2.4%) for each of nodal marginal zone lymphoma and small lymphocytic lymphoma.High pretreatment levels of CA 125 were associated with advanced stage, poor ECOG performance status,high LDH, bone marrow involvment ,presence of B symptoms and extranodal disease .CA-125 levels before and after treatment were higher in those with progressive disease followed by those with partial response and lowest levels were found in those with complete remission.
Conclusion: Higher levels of CA-125 before treatment were associated with advanced , extranodal disease and poor response to chemotherapy.
Introduction: lymphomas are divided into 2 large groups of neoplasms, namely non-Hodgkin lymphoma and Hodgkin lymphoma. Specifying NHL it represent about 85% of all malignant lymphomas. The median age at diagnosis is the sixth decade of life, although Burkitt lymphoma and lymphoblastic lymphoma occur in younger patients. NHL includes B and T cell subtypes , each with distinct epidemiologies, etiologies, morphologic, immunophenotypic, genetic, clinical features and responses to therapy(1).
Caner antigen 125 is an antigenic determinant on a high–molecular-weight glycoprotein recognized by a monoclonal antibody (OC 125). The full-length CA 125 glycoprotein contains more than 11,000 amino acids in its proteinaceous core and has been termed Muc16 to reflect the mucin-like nature of the antigen and is now identified as a new member of the protein family of mucins. The precise function of the antigenic determinant is unknown but can be found in both benign and malignant tissues with normal level reaching 35 units/litre(2).
Up to 80% of women with ovarian carcinoma of epithelial origin have elevated serum CA 125 levels, with the frequency of elevation correlating with the clinically detected stage. The degree of elevation has also been shown to correlate with tumor burden and International Federation of Obstetrics and Gynecologic (FIGO) pathologic stage. However, owing to the lack of sensitivity and specificity, elevations in single or sequential CA 125 levels alone are not recommended for ovarian cancer screening or in the initial diagnosis of ovarian cancer. CA 125 levels may also be elevated in other malignancies, as well as in benign and physiologic conditions(3).
Higher levels of CA 125 were reported in patients with B cell non hodgkin lymphoma having advanced disease, bulky tumours, effusion and/or extra-nodal extension not only that ,but also it was found that higher levels of this tumor marker was correlated with poor response to chemotherapy(4).
|
