Rising CA-125 (Cancer Antigen 125) Levels: Cancer Recurrence or a Vaccine Reaction?

Cancer antigen 125 (CA-125) is a transmembrane glycoprotein, and it is known to be an essential biomarker in detecting treatment response and recurrence of ovarian cancer. It may also be used in monitoring colorectal cancer. It tends to rise in states of inflammation. Recent studies have demonstrated a temporary rise in CA-125 levels and other cancer biomarkers in patients suffering from coronavirus disease 2019 (COVID-19) infection. However, in the following case report, we hope to shed light on a possible association between CA-125 levels and the COVID-19 mRNA vaccine. We present the case of a 79-year-old woman with moderately differentiated adenocarcinoma of the right adnexa, who had a transient increase in CA-125 levels after a period, during which she underwent treatment for COVID-19 infection and received the first dose of COVID-19 mRNA (Pfizer-BioNTech) vaccine with no evidence of disease progression on imaging.

Comparison of Ultrasound and Tumor Marker CA125 in Diagnosis of Adnexal Mass Malignancies.

Background: CA125 is the most used tumor marker for ovarian cancer monitoring and diagnosis. This study aimed to evaluate the capacity to predict malignancy in women with adnexal tumors using CA125 measurement and ultrasound criteria before the pathological examination. Materials and Methods: This observational diagnostic study was conducted on 300 patients with obvious diagnosis of adnexal mass consists of ovarian masses, fallopian tubes, and masses within the broad ligament referring to Alzahra and Beheshti Hospitals from 2018 to 2019. Ultrasound examinations were done before surgery and malignancy risk was investigated by the ADNEX criterion. Sensitivity, specificity, positive and negative likelihood ratio (likelihood ratio [LR]+ and LR-), and area under the curve (AUC) were calculated. Results: From 284 patients, 260 masses were categorized in benign, 18 were in borderline, and 18 masses were malignant. The mean age of patients with malignant tumors was significantly higher than the others (P = 0.01). Differences in the level of CA-125 were not statistically significant (P = 0.78). Furthermore, the proportion of ascites in the malignant group (16.3%) was significantly higher than the others (P = 0.003). The AUC in ADNEX model (cutoff ≥9%) for differentiation of benign and malignant tumors was 0.75 (95% confidence interval [CI]: 0.69-0.80) with a sensitivity of 0.63 (95% CI: 0.41-0.81) and a specificity of 0.80 (95% CI: 0.74-0.84). Receiver operating characteristic analysis for CA-125 revealed that this variable is not capable for discrimination between benign and malignant tumors as the AUCs of the aforementioned variable were 0.60, 0.60, and 0.52 for the whole patients, premenopause, and postmenopause categories. Conclusion: CA-125 marker, along with other ultrasound findings, can be more accurate in identifying the malignancy of the adnexa tumor.

Sandwich-type immunosensor based on COF-LZU1 as the substrate platform and graphene framework supported nanosilver as probe for CA125 detection.

CA125 is a tumor marker which mainly exists in ovarian, the detection for it with high sensitivity is conducive to improve the effectiveness of tumor prevention and control at early state. Multi-layer graphene oxide derivatives from graphene, and has poor conductivity and high stacked properties that limit its further application. Multi-layer reduced graphene oxide frame (MrGOF) was composed of single-layer graphene sheet and exhibited 3D structure with good dispersion, better conductivity and electrochemical properties after multi-layer graphene oxide underwent alkaline peeling and thermally reduction, the modified graphene are easy to load and combine functional groups and metal nanoparticles. Covalent organic frameworks (COFs) presents a stable frame and through covalent bond connection and has porous properties to adsorb biomolecules, which allows the immobilization of antibody molecules by the porosity and improve the sensitivity of the detection in sensing field. Through the adsorption of COFs for antibody and the probe labeled with functional graphene, we constructed a sandwich type immunosensor with the new material COF-LZU1 as the platform to anchor the CA125 first-antibody and MrGOF combined with amino group and loaded with silver nanoparticles (AgNPs) as the probe to detect tumor marker CA125. The linear range of detection was from 0.001 U/mL to 40 U/mL, with the detection limit was calculated to be 0.00023 U/mL (S/N =3). The prepared immunosensor showed a good application ability for real human serum, which can be attributed to the adsorption of COF-LZU1 for the CA125 first-antibody, and ability to deliver electrons and signal amplification of AgNPs anchored on the sheet structure of MrGOF.

The Average Time Gap Between CA-125 Tumor Marker Elevation and Confirmation of Recurrence in Epithelial Ovarian Cancer Patients at Princess Noorah Oncology Center, Jeddah, Saudi Arabia.

The monitoring of the tumor marker cancer antigen 125 (CA-125) is commonly used as a part of epithelial ovarian cancer monitoring for recurrence. This study seeks to calculate the average time between CA-125 elevation above 35 IU/mL and evidence of recurrence through any currently accepted modality (positive clinical findings, biopsy, imaging, or PET [positron emission tomography] findings) in a patient population in Jeddah, Saudi Arabia. We studied patients who were diagnosed between January 2006 and December 2016, underwent successful primary therapy, and were then followed up at Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia. We adopted a cross-sectional chart review study design. We used inclusive (consecutive) sampling. A total of 13 patients were included, of whom 76.9% (10 patients) developed CA-125 elevations above 35 IU/mL prior to the confirmation of recurrence. If all 13 patients are included in the mean average calculation, the mean average time elapsed between CA-125 elevation and confirmation of recurrence was 161.5 days (standard deviation ± 230.6). If only the 10 patients who did exhibit a CA-125 elevation above 35 IU/mL were included, the mean average was 210 days (standard deviation ± 244.2).