Cancer Antigen (CA) 125
Medical Test

Diseases (25)
Screening/Initial Testing (1)
Ovarian cancer screening
7
Note:

May be considered in patients with suspected or known familial cancer syndrome(s). Typically testing is every 6 months beginning at age 30.

Diagnostic Testing (10)
Endometriosis
6
Note:

Not specific for diagnosis, but helpful.

Portal vein thrombosis
6
Note:

If occult malignancy is suspected.

Secondary hypothyroidism
5
Note:

Might be elevated in hypothyroidsm. BMJ 2002 Oct 26;325(7370):946

Disease Management Testing (3)
Other Supportive/Alternative Tests (11)
Actinomycosis
6
Note:

Elevated CA-125 is seen in patients with pelvic actinomycosis.

Cancer of unknown primary site
6
Note:

Aid in diagnosis and management of ovarian cancer.

Benign neoplasm of liver and/or biliary ducts
5
Note:

Not specific, but supportive of diagnosis and treatment.

Hepatocellular carcinoma
5
Note:

Not specific, but might be supportive for diagnosis and treatment.

Malignant neoplasm of testis (Testicular cancer)
5
Note:

Not specific for testicular cancer, but might be supportive for diagnosis and treatment.

Malignant neoplasm, female breast
5
Note:

Not specific for breast cancer, but might be supportive for diagnosis and treatment.

Malignant neoplasm, renal pelvis (kidney)
5
Note:

Not specific for kidney cancer, but might be supportive for diagnosis and treatment.

Malignant neoplasm, uterine cervix (cervical cancer)
5
Note:

Not specific, but supportive for diagnosis and treatment.

Mesothelioma (Malignant pleural mesothelioma)
5
Note:

Not specific for mesothelioma, but can be supportive.

Neoplasm of soft tissue (soft tissue sarcomas)
5
Note:

Not specific, but supportive.

Overview

CA 125 is a cell surface protein often found on ovarian cancer cells and in some normal tissues. It is one of the protein antigens that has been associated with the presence of various cancers, but is most often positive in ovarian cancer. CA 125 concentrations may also be elevated in other types of non-cancerous conditions, including menstruation, pregnancy, and pelvic inflammatory disease. CA 125 is a useful tumor marker for evaluating therapy and monitoring disease status in ovarian cancer patients. As the levels decrease it is an indication that the therapy or treatment is working. Post-operatively, the CA 125 concentration correlates with tumor bulk and is a prognostic indicator of clinical outcome. It has been reported that patients with levels exceeding 35 U/mL have the highest risk for clinical recurrence. CA 125 is not useful as a screening mechanism because it is elevated in many non-cancerous conditions, although women that are at higher risk due to family history or other reasons are usually tested regularly as a precautionary method.

Measured serially, serum CA 125 concentration typically corresponds with disease progression or regression. The rate of change in CA 125 is also highly prognostic. A rapid decrease in the level of CA 125 indicates a positive response to treatment. Elevated levels of CA 125 after the third course of primary chemotherapy are typically predictive of poor outcomes.

Clinical Utility
  • Monitoring and management of ovarian cancer of epithelial type, including monitoring for disease after initial treatment.
  • Management of ovarian epithelial cancer patients with metastatic disease by monitoring the progression or regression of disease response to treatment

Interpretation

Increased in:

  • Ovarian cancer of epithelial types
  • Pelvic inflammatory disease
  • Some other cancers
  • Cancer of endometrium
  • Cancer of fallopian tube
  • Some physiological conditions such as pregnancy, menstruation
  • Endometriosis
  • Ovarian cysts

Note: Normal levels do not exclude recurrent malignancy.

Reference Ranges

 <30 U/mL

 

 

Methodology

Enzyme Immunoassay, ELISA

Specimen Collection

Serum (SST)

Stability:

  • Ambient: 24 hours
  • Refrigerated: 7 days
  • Frozen: 60 days
  • Separate sample within 1 hour of collection and keep refrigerated or frozen.

Additional Testing

Carcinoembryonic antigen (CEA), CA 15-3, CA 19-9, Follicle Stimulating Hormone, Luteinizing Hormone, HCG, Progesterone, HE4.

CPT
86304$20.81

ICD10
ICD CODE AND DESCRIPTIONLCD CODENCD CODE
A42 - Actinomycosis—190.28
A42.0 - Pulmonary actinomycosis—190.28
A42.1 - Abdominal actinomycosis—190.28
A42.2 - Cervicofacial actinomycosis—190.28
A42.7 - Actinomycotic sepsis—190.28
A42.8 - Other forms of actinomycosis—190.28
A42.81 - Actinomycotic meningitis—190.28
A42.82 - Actinomycotic encephalitis—190.28
A42.89 - Other forms of actinomycosis—190.28
A42.9 - Actinomycosis, unspecified—190.28
C22 - Malignant neoplasm of liver and intrahepatic bile ducts—190.28
C22.0 - Liver cell carcinoma—190.28
C22.8 - Malignant neoplasm of liver, primary, unspecified as to type—190.28
C25 - Malignant neoplasm of pancreas—190.28
C25.0 - Malignant neoplasm of head of pancreas—190.28
C25.1 - Malignant neoplasm of body of pancreas—190.28
C25.2 - Malignant neoplasm of tail of pancreas—190.28
C25.4 - Malignant neoplasm of endocrine pancreas—190.28
C25.7 - Malignant neoplasm of other parts of pancreas—190.28
C25.8 - Malignant neoplasm of overlapping sites of pancreas—190.28
C25.9 - Malignant neoplasm of pancreas, unspecified—190.28
C38 - Malignant neoplasm of heart, mediastinum and pleura—190.28
C38.0 - Malignant neoplasm of heart—190.28
C38.1 - Malignant neoplasm of anterior mediastinum—190.28
C38.2 - Malignant neoplasm of posterior mediastinum—190.28
C38.3 - Malignant neoplasm of mediastinum, part unspecified—190.28
C38.4 - Malignant neoplasm of pleura—190.28
C38.8 - Malignant neoplasm of overlapping sites of heart, mediastinum and pleura—190.28
C39 - Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs—190.28
C39.0 - Malignant neoplasm of upper respiratory tract, part unspecified—190.28
C43.52 - Malignant melanoma of skin of breast—190.28
C44 - Other and unspecified malignant neoplasm of skin—190.28
C45 - Mesothelioma—190.28
C45.0 - Mesothelioma of pleura—190.28
C45.1 - Mesothelioma of peritoneum—190.28
C45.2 - Mesothelioma of pericardium—190.28
C45.7 - Mesothelioma of other sites—190.28
C45.9 - Mesothelioma, unspecified—190.28
C48 - Malignant neoplasm of retroperitoneum and peritoneum—190.28
C48.0 - Malignant neoplasm of retroperitoneum—190.28
C48.1 - Malignant neoplasm of specified parts of peritoneum—190.28
C48.2 - Malignant neoplasm of peritoneum, unspecified—190.28
C48.8 - Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum—190.28
C49 - Malignant neoplasm of other connective and soft tissue—190.28
C49.8 - Malignant neoplasm of overlapping sites of connective and soft tissue—190.28
C49.9 - Malignant neoplasm of connective and soft tissue, unspecified—190.28
C50 - Malignant neoplasm of breast—190.28
C50.01 - Malignant neoplasm of nipple and areola, female—190.28
C50.011 - Malignant neoplasm of nipple and areola, right female breast—190.28
C50.012 - Malignant neoplasm of nipple and areola, left female breast—190.28

Additional ICD10
ICD CODE AND DESCRIPTIONLCD CODENCD CODE
A42.0 - Pulmonary actinomycosis—190.28
A42.1 - Abdominal actinomycosis—190.28
A42.2 - Cervicofacial actinomycosis—190.28
A42.7 - Actinomycotic sepsis—190.28
A42.8 - Other forms of actinomycosis—190.28
A42.81 - Actinomycotic meningitis—190.28
A42.82 - Actinomycotic encephalitis—190.28
A42.89 - Other forms of actinomycosis—190.28
A42.9 - Actinomycosis, unspecified—190.28
C22.0 - Liver cell carcinoma—190.28
C22.1 - Intrahepatic bile duct carcinoma—190.28
C22.2 - Hepatoblastoma—190.28
C22.3 - Angiosarcoma of liver—190.28
C22.4 - Other sarcomas of liver—190.28
C22.7 - Other specified carcinomas of liver—190.28
C22.8 - Malignant neoplasm of liver, primary, unspecified as to type—190.28
C22.9 - Malignant neoplasm of liver, not specified as primary or secondary—190.28
C25.0 - Malignant neoplasm of head of pancreas—190.28
C25.1 - Malignant neoplasm of body of pancreas—190.28
C25.2 - Malignant neoplasm of tail of pancreas—190.28
C25.3 - Malignant neoplasm of pancreatic duct—190.28
C25.4 - Malignant neoplasm of endocrine pancreas—190.28
C25.7 - Malignant neoplasm of other parts of pancreas—190.28
C25.8 - Malignant neoplasm of overlapping sites of pancreas—190.28
C25.9 - Malignant neoplasm of pancreas, unspecified—190.28
C38.0 - Malignant neoplasm of heart—190.28
C38.1 - Malignant neoplasm of anterior mediastinum—190.28
C38.2 - Malignant neoplasm of posterior mediastinum—190.28
C38.3 - Malignant neoplasm of mediastinum, part unspecified—190.28
C38.4 - Malignant neoplasm of pleura—190.28
C38.8 - Malignant neoplasm of overlapping sites of heart, mediastinum and pleura—190.28
C39.0 - Malignant neoplasm of upper respiratory tract, part unspecified—190.28
C39.9 - Malignant neoplasm of lower respiratory tract, part unspecified—190.28
C44.0 - Other and unspecified malignant neoplasm of skin of lip—190.28
C44.00 - Unspecified malignant neoplasm of skin of lip—190.28
C44.01 - Basal cell carcinoma of skin of lip—190.28
C44.02 - Squamous cell carcinoma of skin of lip—190.28
C44.09 - Other specified malignant neoplasm of skin of lip—190.28
C44.1 - Other and unspecified malignant neoplasm of skin of eyelid, including canthus—190.28
C44.10 - Unspecified malignant neoplasm of skin of eyelid, including canthus—190.28
C44.101 - Unspecified malignant neoplasm of skin of unspecified eyelid, including canthus—190.28
C44.102 - Unspecified malignant neoplasm of skin of right eyelid, including canthus—190.28
C44.1021 - Unspecified malignant neoplasm of skin of right upper eyelid, including canthus—190.28
C44.1022 - Unspecified malignant neoplasm of skin of right lower eyelid, including canthus—190.28
C44.109 - Unspecified malignant neoplasm of skin of left eyelid, including canthus—190.28
C44.1091 - Unspecified malignant neoplasm of skin of left upper eyelid, including canthus—190.28
C44.1092 - Unspecified malignant neoplasm of skin of left lower eyelid, including canthus—190.28
C44.11 - Basal cell carcinoma of skin of eyelid, including canthus—190.28
C44.111 - Basal cell carcinoma of skin of unspecified eyelid, including canthus—190.28
C44.112 - Basal cell carcinoma of skin of right eyelid, including canthus—190.28

References