CA125

Cancer

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CA 125 is a high-molecular-weight glycoprotein secreted by coelomic epithelium-derived tissues, especially the epithelial lining of the ovaries

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CA125 Test Information Guide

Why is it done?
- CA125 (Cancer Antigen 125) is a protein found on the surface of ovarian cancer cells and other cell types. The test measures the level of this antigen in the blood.
- Screening and monitoring ovarian cancer in women with a family history or known risk factors
- Monitoring treatment response and detecting recurrence in ovarian cancer patients
- Evaluating pelvic masses and abnormal imaging findings
- Assessing prognosis and stage of ovarian cancer at diagnosis
- Detecting other malignancies including endometrial, fallopian tube, and peritoneal cancers
- Typically performed during initial cancer evaluation, periodically during treatment, and during follow-up surveillance after treatment completion
Normal Range
- Normal/Reference Range: Less than 35 U/mL (units per milliliter) is generally considered normal
- Units of Measurement: U/mL (units per milliliter)
- Result Interpretation:
- Below 35 U/mL = Normal (Negative) - Unlikely to indicate cancer, though does not completely rule it out
- 35-65 U/mL = Borderline Elevated - May warrant further evaluation and repeat testing
- Above 65 U/mL = Significantly Elevated (Positive) - Suggests possible malignancy or other serious pathology; requires immediate investigation
- Normal results do not exclude cancer, particularly in early-stage disease where CA125 may remain within normal limits
Interpretation
- Elevated Levels (>35 U/mL): May indicate ovarian, endometrial, or peritoneal cancer; also associated with non-cancerous conditions such as endometriosis, fibroids, pelvic inflammatory disease, cirrhosis, and pancreatitis
- Progressive Elevation: Rising CA125 levels on serial measurements are more concerning than a single elevated value and may indicate cancer progression or recurrence
- Decreasing Levels During Treatment: Favorable indicator of treatment response; return to normal levels suggests successful cancer management
- Rapid Rise After Plateau: May indicate cancer recurrence or resistance to treatment; warrants additional imaging and clinical assessment
- Factors Affecting Results:
- Menstrual cycle phase - may slightly elevate levels
- Benign gynecologic conditions - endometriosis, fibroids, cysts
- Liver disease and cirrhosis - can elevate CA125 independently
- Recent surgery or trauma - temporary elevation possible
- Inflammatory conditions - pancreatitis, peritonitis
- Clinical Significance: CA125 is not a standalone diagnostic tool and must be interpreted in conjunction with imaging studies, clinical symptoms, and physical examination findings. Most useful in monitoring known cancer cases rather than screening healthy populations.
Associated Organs
- Primary Organ Systems: Reproductive system (ovaries, fallopian tubes, uterus, peritoneum); also found in normal cells of the endometrium and mesothelial tissues
- Cancers Associated with Elevated CA125:
- Ovarian cancer (most common association)
- Primary peritoneal cancer
- Fallopian tube cancer
- Endometrial (uterine) cancer
- Breast cancer
- Lung cancer
- Pancreatic cancer
- Gastrointestinal malignancies
- Non-Cancerous Conditions with Elevated CA125:
- Endometriosis and adenomyosis
- Uterine fibroids and ovarian cysts
- Pelvic inflammatory disease and infections
- Hepatic cirrhosis and liver disease
- Peritonitis and ascites
- Acute pancreatitis
- Potential Complications of Associated Cancers:
- Metastatic spread to peritoneum, liver, and distant organs
- Malignant ascites and bowel obstruction
- Vascular invasion and thromboembolism
- Severe infection and sepsis if cancer erodes through tissue
Follow-up Tests
- Imaging Studies:
- Transvaginal ultrasound - first-line imaging for evaluating pelvic masses in women with elevated CA125
- CT scan of abdomen and pelvis - staging and detecting metastatic disease
- MRI pelvis - provides additional soft tissue characterization when indicated
- PET-CT scan - helpful in detecting recurrent disease and metastases
- Additional Tumor Markers:
- HE4 (Human Epididymis Protein 4) - improved specificity when combined with CA125
- CEA (Carcinoembryonic Antigen) - if gastrointestinal malignancy suspected
- AFP (Alpha-fetoprotein) - in cases of ovarian germ cell tumors
- Genetic Testing:
- BRCA1/BRCA2 mutation testing - recommended for patients with ovarian cancer or strong family history
- Tissue Diagnosis:
- Tissue biopsy or fine needle aspiration - definitive diagnosis of malignancy
- Laboratory Tests:
- Complete blood count - assess for anemia, thrombocytopenia
- Comprehensive metabolic panel - evaluate organ function before treatment
- Liver and renal function tests - important for patients receiving chemotherapy
- Monitoring Frequency:
- During active cancer treatment: every 1-3 months depending on treatment plan
- During surveillance following treatment: every 3-6 months for first 2-3 years, then annually
- Testing frequency adjusted based on clinical presentation and symptom development
Fasting Required?
- Fasting Required: No
- CA125 blood test does not require fasting - you may eat and drink normally before the test
- Special Instructions:
- Inform the healthcare provider if you are menstruating or have recently had pelvic surgery, as these factors may temporarily affect results
- Continue taking all regular medications unless specifically instructed otherwise by your physician
- Wear comfortable clothing with easy access to the upper arm for blood draw
- Arrive well-hydrated for easier blood collection
- Inform the phlebotomist if you have a history of fainting or needle anxiety
- Medications: No medications need to be avoided for this test. Take all regular medications as prescribed.
- Test Timing: Can be performed at any time of day; approximately 5-10 minutes for blood collection

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