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Revista de la Facultad de Medicina
Print version ISSN 0120-0011
Abstract
LEIB, Carl Sebastián; PARRA-LARA, Luis Gabriel; PACHECO, Robinson and GARCIA-GOEZ, José Fernando. Clinical usefulness of cancer antigen 125 biomarker for diagnosing tuberculosis: experience in Cali, Colombia. rev.fac.med. [online]. 2022, vol.70, n.3, e205. Epub Feb 03, 2023. ISSN 0120-0011. https://doi.org/10.15446/revfacmed.v70n3.92921.
Introduction:
Diagnosing extra-pulmonary tuberculosis (EPTB) is a challenge for physicians. It has been suggested that cancer antigen 125 (CA-125), which is produced by mesothelial cells, may be an EPTB diagnostic biomarker.
Objective:
To describe serum CA-125 levels behavior in patients with TB treated in a referral university hospital located in Cali, Colombia.
Materials and methods:
A cross-sectional study was conducted in 99 TB patients treated at Fundación Valle del Lili between 2007 and 2016 with CA-125 measurements (U/mL) made before TB treatment was started. Cases were classified as pulmonary TB (PTB) (n=33) or EPTB (n=66). A bivariate analysis was performed to compare the variables of interest (sociodemographic, clinical, and laboratory findings data) between EPTB and PTB groups, and to determine differences between patients with CA-125 positive results and those with negative results in relation to mortality.
Results:
Elevated CA-125 levels were reported in 55 patients (55.56%), and positive CA-125 results (>35 U/mL) were more frequent in the EPTB group (59.09% vs. 48.48%). In the EPTB group, results were positive in tuberculous serositis cases (100% pericardial TB, 68.42% peritoneal TB, and 66.66% pleural TB), and in 66.66% of miliary TB and spinal TB cases, respectively. Also, 15 TB infection-related deaths were reported in the follow-up period (n=66), of which 13 had a CA-125 positive result, finding a significant difference with those with negative results (p=0.021); however, 47.05% of the surviving patients also had a positive result.
Conclusions:
Most of tuberculous serositis, miliary TB, and spinal TB cases showed elevated CA-125 levels before starting TB treatment. Therefore, CA-125 may be useful for prognostic purposes in these patients.
Keywords : Mycobacterium tuberculosis; Tuberculosis; CA-125 Antigen; Biomarkers; Mortality (MeSH).