Background: Cancer antigen-125 is a high molecular weight glycoprotein used mainly for the diagnosis of ovarian carcinoma. However, elevation of cancer antigen-125 is observed in many benign conditions specially in liver cirrhosis but the reason behind the elevation remains unknown. Similarly intercellular adhesion molecule (ICAM-1) elevation is reported in liver cirrhosis but its role played in liver cirrhosis and ascites is unclear.
Methods: A total of 76 patients were involved in the study diagnosed with liver cirrhosis, Budd-Chairi syndrome, and tuberculous peritonitis. The degree of ascites was graded according to standard criteria into mild, moderate and severe. Cancer antigen-125 levels and sICAM-1 levels of all the patients were measured along with other liver parameters to evaluate the association of CA-125 and sICAM-1 with ascites.
Results: When cancer antigen-125 levels of liver cirrhosis patients were correlated with ascites a strong correlation was observed with the degree of ascites but no association was seen with liver function parameters. A significant difference was shown when liver cirrhosis patients with ascites were compared with liver cirrhosis patients without ascites (p < 0.05). All the patients with ascites had elevated levels of CA-125 (mean: 261.11 U/mL +/- 118.15 U/mL) whereas most of the patients without ascites had CA-125 levels under the normal range. A strong correlation (p < 0.05) is seen between CA-125 level and the degree of ascites. Elevated levels of sICAM-1 were observed in liver cirrhosis patients with ascites as well as in patients with other benign diseases with ascites (mean sICAM-1: 7.23 +/- 4.12 ng/mL and 6.67 +/- 2.99 ng/mL, respectively). When sICAM levels of liver cirrhosis patients with and without ascites were compared a significant difference (p < 0.05) is observed.
Conclusions: The elevation of cancer antigen-125 in liver cirrhosis is specific to ascites. The mesothelial cells of the peritoneum chiefly contribute to the elevation of cancer antigen-125 along with the large surface area of the peritoneum. Therefore, CA-125 can be used as a good marker for early diagnosis of ascites and CA-125 has no relationship with the etiology of diseases in benign ascites. ICAM-1 plays a key role in the formation of ascites by influencing the endothelial-vascular permeability and therefore it along with CA-125 can be used as markers or alternative tools to diagnose ascites and to monitor the progression and severity of the disease.
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