Diseases (14)

Screening/Initial Testing (1)

Note:

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

Other Supportive/Alternative Tests (1)

Note:

Aid in diagnosis and management of ovarian cancer.

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.

Turnaround Time

1-3 days.

CPT

86304

ICD10

C25Malignant neoplasm of pancreas
C25.0Malignant neoplasm of head of pancreas
C25.1Malignant neoplasm of body of pancreas
C25.2Malignant neoplasm of tail of pancreas
C25.7Malignant neoplasm of other parts of pancreas
C25.9Malignant neoplasm of pancreas, unspecified
C48Malignant neoplasm of retroperitoneum and peritoneum
C48.0Malignant neoplasm of retroperitoneum
C48.1Malignant neoplasm of specified parts of peritoneum
C48.2Malignant neoplasm of peritoneum, unspecified
C48.8Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum
C54Malignant neoplasm of corpus uteri
C54.0Malignant neoplasm of isthmus uteri
C54.1Malignant neoplasm of endometrium
C54.2Malignant neoplasm of myometrium
C54.3Malignant neoplasm of fundus uteri
C54.9Malignant neoplasm of corpus uteri, unspecified
C56Malignant neoplasm of ovary
C56.1Malignant neoplasm of right ovary
C56.2Malignant neoplasm of left ovary
C56.9Malignant neoplasm of unspecified ovary
C57.00Malignant neoplasm of unspecified fallopian tube
C57.01Malignant neoplasm of right fallopian tube
C57.02Malignant neoplasm of left fallopian tube
C78Secondary malignant neoplasm of respiratory and digestive organs
C78.0Secondary malignant neoplasm of lung
C78.00Secondary malignant neoplasm of unspecified lung
C78.2Secondary malignant neoplasm of pleura
C78.4Secondary malignant neoplasm of small intestine
C78.89Secondary malignant neoplasm of other digestive organs
C79.00Secondary malignant neoplasm of unspecified kidney and renal pelvis
C79.11Secondary malignant neoplasm of bladder
C79.2Secondary malignant neoplasm of skin
C79.31Secondary malignant neoplasm of brain
C79.49Secondary malignant neoplasm of other parts of nervous system
C79.51Secondary malignant neoplasm of bone
C79.52Secondary malignant neoplasm of bone marrow
C79.6Secondary malignant neoplasm of ovary
C79.7Secondary malignant neoplasm of adrenal gland
C79.81Secondary malignant neoplasm of breast
C79.82Secondary malignant neoplasm of genital organs
C79.89Secondary malignant neoplasm of other specified sites
C79.9Secondary malignant neoplasm of unspecified site
C80Malignant neoplasm without specification of site
C80.0Disseminated malignant neoplasm, unspecified
C80.1Malignant (primary) neoplasm, unspecified
C80.2Malignant neoplasm associated with transplanted organ
D21Other benign neoplasms of connective and other soft tissue
D27Benign neoplasm of ovary
D27.0Benign neoplasm of right ovary
D27.1Benign neoplasm of left ovary
D27.9Benign neoplasm of unspecified ovary
E00Congenital iodine-deficiency syndrome
E02Subclinical iodine-deficiency hypothyroidism
E03Other hypothyroidism
E03.8Other specified hypothyroidism
E03.9Hypothyroidism, unspecified
E89.0Postprocedural hypothyroidism
N80Endometriosis
N80.0Endometriosis of uterus
N80.9Endometriosis, unspecified
N85.02Endometrial intraepithelial neoplasia [EIN]
R97Abnormal tumor markers
R97.0Elevated carcinoembryonic antigen [CEA]
R97.1Elevated cancer antigen 125 [CA 125]
Z12.73Encounter for screening for malignant neoplasm of ovary
Z12.8Encounter for screening for malignant neoplasm of other sites
Z12.89Encounter for screening for malignant neoplasm of other sites
Z85Personal history of malignant neoplasm
Z85.07Personal history of malignant neoplasm of pancreas
Z85.42Personal history of malignant neoplasm of other parts of uterus
Z85.43Personal history of malignant neoplasm of ovary
Z85.44Personal history of malignant neoplasm of other female genital organs

References