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词条 CA-125
释义

  1. Structure

  2. Function

  3. As a biomarker

     Early detection of ovarian cancer   Specificity and sensitivity    Ranges in ovarian cancer  

  4. Role in cancer

     Immune system evasion  Metastatic invasion  Induced motility  Chemotherapy resistance 

  5. Discovery

  6. References

  7. Further reading

  8. External links

{{for|the highway|California State Route 125}}{{Infobox_gene}}

CA-125 (cancer antigen 125, carcinoma antigen 125, or carbohydrate antigen 125) also known as mucin 16 or MUC16 is a protein that in humans is encoded by the MUC16 gene.[1][2] MUC16 is a member of the mucin family glycoproteins.[3] CA-125 has found application as a tumor marker or biomarker that may be elevated in the blood of some patients with specific types of cancers,[4] or other conditions that are benign.

Structure

Mucin 16 is a membrane associated mucin that possesses a single transmembrane domain.[5] A unique property of MUC16 is its large size. MUC16 is more than twice as long as MUC1 and MUC4 and contains about 22,000 amino acids, making it the largest membrane-associated mucin.[6]

MUC16 is composed of three different domains:[7]

  • An N-terminal domain
  • A tandem repeat domain
  • A C-terminal domain

The N-terminal and tandem repeat domains are both entirely extracellular and highly O-glycosylated. All mucins contain a tandem repeat domain that has repeating amino acid sequences high in serine, threonine and proline.[8] The C-terminal domain contains multiple extracellular SEA (sea urchin sperm protein, enterokinase, and agrin) modules,[9] a transmembrane domain, and a cytoplasmic tail.[7] The extracellular region of MUC16 can be released from the cell surface by undergoing proteolytic cleavage.[10] MUC16 is thought to be cleaved at a site in the SEA modules.[11]

Function

MUC16 is a component of the ocular surface (including the cornea and conjunctiva), the respiratory tract and the female reproductive tract epithelia. Since MUC16 is highly glycosylated it creates a hydrophilic environment that acts as a lubricating barrier against foreign particles and infectious agents on the apical membrane of epithelial cells.[12] Also, the cytoplasmic tail of MUC16 has been shown to interact with cytoskeleton by binding members of the ERM protein family.[13] The expression of mucin 16 has been shown to be altered in dry eye, cystic fibrosis, and several types of cancers.[14]

As a biomarker

CA-125 is the most frequently used biomarker for ovarian cancer detection.[15] Medical societies including American Congress of Obstetricians and Gynecologists recommend against women with average risk of ovarian cancer having routine CA-125 screening or other screening for this cancer.[16] Reasons for this include evidence that ambiguous test results are more likely to lead to further invasive, harmful, and unnecessary health care than they are likely to detect ovarian cancer in women who are at average risk of developing it.[16]

Around 90% of women with advanced ovarian cancer have elevated levels of CA-125 in their blood serum, making CA-125 a useful tool for detecting ovarian cancer after the onset of symptoms.[17] Monitoring CA-125 blood serum levels is also useful for determining how ovarian cancer is responding to treatment (with the duration of disease-free survival correlating with the rate of fall of CA-125)[18] and for predicting a patient’s prognosis after treatment.[19] This is because the persistence of high levels of CA-125 during therapy is associated with poor survival rates in patients.[19] Also, an increase in CA-125 levels within individuals in a remission is a strong predictor of the recurrence of ovarian cancer.[20] Indeed, a rising CA-125 level may precede clinical evidence of disease relapse by an interval of 3 to 6 months.

Prognosis relates to both the initial and post-treatment CA-125 values. A preoperative value >65 U/mL suggests a poor prognosis. Persistent elevations following chemotherapy indicate a poor prognosis. The half-life of CA-125 after chemotherapy correlates with prognosis (patients with CA-125 half-life <20 days show improved survival). Time-to-normalization (rate of fall of CA-125) affects prognosis with more rapid normalization within 3 cycles of chemotherapy correlating with improved survival.[21]

In April 2011 the UK's National Institute for Health and Clinical Excellence (NICE) recommended that women with symptoms that could be caused by ovarian cancer should be offered a CA-125 blood test.[22] The aim of this guideline is to help diagnose the disease at an earlier stage, when treatment is more likely to be successful. Women with higher levels of the marker in their blood would then be offered an ultrasound scan to determine whether they need further tests.

In one case, elevated serum levels of CA-125 were observed in a male patient with IgE myeloma, however more cases are needed to determine the clinical significance of CA-125 in myeloma.[23]

Early detection of ovarian cancer

The potential role of CA-125 for the early detection of ovarian cancer is controversial and has not yet been adopted for widespread screening efforts in asymptomatic women.[24][25] The major issues with using the CA-125 biomarker are its lack of sensitivity, particularly for detecting early stages of ovarian cancer, and its lack of specificity, especially in premenopausal women.[26] These limitations mean that CA-125 testing often gives false positives for ovarian cancer and puts patients through unnecessary further screening (sometimes including surgery) and anxiety.[20] Also, these limitations mean that many women with early stage ovarian cancer will receive a false negative from CA-125 testing and not get further treatment for their condition.[27]

Specificity and sensitivity

CA-125 has limited specificity for ovarian cancer because elevated CA-125 levels can be found in individuals without ovarian cancer. For example, while CA-125 is best known as a marker for ovarian cancer,[28] it may also be elevated in other cancers, including endometrial cancer, fallopian tube cancer, lung cancer, breast cancer and gastrointestinal cancer.[4] CA-125 may also be elevated in a number of relatively benign conditions, such as endometriosis,[29] several diseases of the ovary, menstruation[26] and pregnancy.[30] It also tends to be elevated in the presence of any inflammatory condition in the abdominal area, both cancerous and benign,[31] as well as in cirrhosis and diabetes mellitus.[32] Thus, CA-125 testing is not perfectly specific for ovarian cancer and often results in false positives.[26]

The specificity of CA-125 is particularly low in premenopausal women because many benign conditions that cause fluctuations in CA-125 levels, such as menstruation, pregnancy, and pelvic inflammatory disease, are seen in this population.[25]

CA-125 testing is also not perfectly sensitive for detecting ovarian cancer because not every patient with cancer will have elevated levels of CA-125 in their blood.[33] For example, 79% of all ovarian cancers are positive for CA-125, whereas the remainder do not express this antigen at all.[34] Also, only about 50% of patients with early stage ovarian cancer have elevated CA-125 levels, meaning that CA-125 has particularly poor sensitivity for ovarian cancer before the onset of symptoms.[26][35] Poor sensitivity means that the use of CA-125 to detect ovarian cancer (especially in early stages of disease) can frequently lead to false negatives. Patients that receive false negatives are unlikely to seek further treatment for their disease.

Ranges in ovarian cancer

While this test is not generally regarded as useful for large scale screening by the medical community, a high value may be an indication that the woman should receive further diagnostic screening or treatment. Normal values range from 0 to 35 (U/mL).[26] Elevated levels in post-menopausal women are usually an indication that further screening is necessary. In pre-menopausal women, the test is less reliable as values are often elevated due to a number of non-cancerous causes, and a value above 35 is not necessarily a cause for concern.[25]

In a patient who is clinically selected for testing due to the presence of an adnexal/pelvic mass, CA-125 has great utility to differentiate benign from malignant processes. In a post-menopausal woman with a palpable adnexal mass and CA-125 level greater than 65 U/mL, the positive predictive value is >95% for ovarian malignancy. In patients who are not as carefully selected clinically, the utility of this test decreases, thus highlighting the need for careful clinical scrutiny.

Role in cancer

MUC16 (CA-125) has been shown to play a role in advancing tumorigenesis and tumor proliferation by several different mechanisms.

Immune system evasion

One way that MUC16 helps the growth of tumors is by suppressing the response of natural killer cells, thereby protecting cancer cells from the immune response.[36] Further evidence that MUC16 can protect tumor cells from the immune system is the discovery that the heavily glycosylated tandem repeat domain of MUC16 can bind to galectin-1 (an immunosuppressive protein).[37]

Metastatic invasion

MUC16 is also thought to participate in cell-to-cell interactions that enable the metastasis of tumor cells. This is supported by evidence showing that MUC16 binds selectively to mesothelin, a glycoprotein normally expressed by the mesothelial cells of the peritoneum (the lining of the abdominal cavity).[38] MUC16 and mesothelin interactions are thought to provide the first step in tumor cell invasion of the peritoneum.[39] The region (residues 296-359) consisting of 64 amino acids at the N-terminus of cell surface mesothelin has been experimentally established as the functional binding domain (named IAB) for MUC16/CA125.[40] An immunoadhesin that consists of the IAB domain of mesothelin and the human Fc portion has the ability to disrupt the heterotypic cancer cell adhesion mediated by the MUC16-mesothelin interaction.[41]

Mesothelin has also been found to be expressed in several types of cancers including mesothelioma, ovarian cancer and squamous cell carcinoma.[42] Since mesothelin is also expressed by tumor cells, MUC16 and mesothelial interactions may aid in the gathering of other tumor cells to the location of a metastasis, thus increasing the size of the metastasis.[39]

Induced motility

Evidence suggests that expression of the cytoplasmic tail of MUC16 enables tumor cells to grow, promotes cell motility and may facilitate invasion. This appears to be due to the ability of the C-terminal domain of MUC16 to facilitate signaling that leads to a decrease in the expression of E-cadherin and increase the expression of N-cadherin and vimentin, which are expression patterns consistent with epithelial-mesenchymal transition.[43]

Chemotherapy resistance

MUC16 may also play a role in reducing the sensitivity of cancer cells to drug therapy. For example, overexpression of MUC16 has been shown to protect cells from the effects of genotoxic drugs, such as cisplatin.[44]

Discovery

CA-125 was initially detected using the murine monoclonal antibody designated OC125. Robert Bast, Robert Knapp and their research team first isolated this monoclonal antibody in 1981.[45] The protein was named “cancer antigen 125” because OC125 was the 125th antibody produced against the ovarian cancer cell line that was being studied.[46]

References

1. ^{{cite journal | vauthors = Yin BW, Lloyd KO | title = Molecular cloning of the CA125 ovarian cancer antigen: identification as a new mucin, MUC16 | journal = The Journal of Biological Chemistry | volume = 276 | issue = 29 | pages = 27371–5 | date = Jul 2001 | pmid = 11369781 | doi = 10.1074/jbc.M103554200 }}
2. ^{{cite journal | vauthors = Yin BW, Dnistrian A, Lloyd KO | title = Ovarian cancer antigen CA125 is encoded by the MUC16 mucin gene | journal = International Journal of Cancer | volume = 98 | issue = 5 | pages = 737–40 | date = Apr 2002 | pmid = 11920644 | doi = 10.1002/ijc.10250 }}
3. ^{{cite journal | vauthors = Duraisamy S, Ramasamy S, Kharbanda S, Kufe D | title = Distinct evolution of the human carcinoma-associated transmembrane mucins, MUC1, MUC4 AND MUC16 | journal = Gene | volume = 373 | issue = | pages = 28–34 | date = May 2006 | pmid = 16500040 | doi = 10.1016/j.gene.2005.12.021 }}
4. ^1 {{cite journal | vauthors = Bast RC, Xu FJ, Yu YH, Barnhill S, Zhang Z, Mills GB | title = CA 125: the past and the future | journal = The International Journal of Biological Markers | volume = 13 | issue = 4 | pages = 179–87 | year = 1998 | pmid = 10228898 | doi = 10.1177/172460089801300402}}
5. ^{{cite journal | vauthors = Gipson IK | title = The ocular surface: the challenge to enable and protect vision: the Friedenwald lecture | journal = Investigative Ophthalmology & Visual Science | volume = 48 | issue = 10 | pages = 4390; 4391–8 | date = Oct 2007 | pmid = 17898256 | pmc = 2886589 | doi = 10.1167/iovs.07-0770 }}
6. ^{{cite journal | vauthors = Gniewek P, Kolinski A | title = Coarse-grained modeling of mucus barrier properties | journal = Biophysical Journal | volume = 102 | issue = 2 | pages = 195–200 | date = Jan 2012 | pmid = 22339855 | pmc = 3260744 | doi = 10.1016/j.bpj.2011.11.4010 }}
7. ^1 {{cite journal | vauthors = O'Brien TJ, Beard JB, Underwood LJ, Dennis RA, Santin AD, York L | title = The CA 125 gene: an extracellular superstructure dominated by repeat sequences | journal = Tumour Biology | volume = 22 | issue = 6 | pages = 348–66 | date = Nov–Dec 2001 | pmid = 11786729 | pmc = | doi = 10.1159/000050638 }}
8. ^{{cite journal | vauthors = Hollingsworth MA, Swanson BJ | title = Mucins in cancer: protection and control of the cell surface | journal = Nature Reviews. Cancer | volume = 4 | issue = 1 | pages = 45–60 | date = Jan 2004 | pmid = 14681689 | doi = 10.1038/nrc1251 }}
9. ^{{cite journal | vauthors = Kufe DW | title = Mucins in cancer: function, prognosis and therapy | journal = Nature Reviews. Cancer | volume = 9 | issue = 12 | pages = 874–85 | date = Dec 2009 | pmid = 19935676 | pmc = 2951677 | doi = 10.1038/nrc2761 }}
10. ^{{cite journal | vauthors = Goodell CA, Belisle JA, Gubbels JA, Migneault M, Rancourt C, Connor J, Kunnimalaiyaan M, Kravitz R, Tucker W, Zwick M, Patankar MS | title = Characterization of the tumor marker muc16 (ca125) expressed by murine ovarian tumor cell lines and identification of a panel of cross-reactive monoclonal antibodies | journal = Journal of Ovarian Research | volume = 2 | issue = 1 | pages = 8 | year = 2009 | pmid = 19538730 | pmc = 2708168 | doi = 10.1186/1757-2215-2-8 }}
11. ^{{cite journal | vauthors = Palmai-Pallag T, Khodabukus N, Kinarsky L, Leir SH, Sherman S, Hollingsworth MA, Harris A | title = The role of the SEA (sea urchin sperm protein, enterokinase and agrin) module in cleavage of membrane-tethered mucins | journal = The FEBS Journal | volume = 272 | issue = 11 | pages = 2901–11 | date = Jun 2005 | pmid = 15943821 | doi = 10.1111/j.1742-4658.2005.04711.x }}
12. ^{{cite journal | vauthors = Perez BH, Gipson IK | title = Focus on Molecules: human mucin MUC16 | journal = Experimental Eye Research | volume = 87 | issue = 5 | pages = 400–1 | date = Nov 2008 | pmid = 18289532 | pmc = 2586928 | doi = 10.1016/j.exer.2007.12.008 }}
13. ^{{cite journal | vauthors = Blalock TD, Spurr-Michaud SJ, Tisdale AS, Heimer SR, Gilmore MS, Ramesh V, Gipson IK | title = Functions of MUC16 in corneal epithelial cells | journal = Investigative Ophthalmology & Visual Science | volume = 48 | issue = 10 | pages = 4509–18 | date = Oct 2007 | pmid = 17898272 | doi = 10.1167/iovs.07-0430 }}
14. ^{{cite journal | vauthors = Bafna S, Kaur S, Batra SK | title = Membrane-bound mucins: the mechanistic basis for alterations in the growth and survival of cancer cells | journal = Oncogene | volume = 29 | issue = 20 | pages = 2893–904 | date = May 2010 | pmid = 20348949 | pmc = 2879972 | doi = 10.1038/onc.2010.87 }}
15. ^{{cite journal | vauthors = Suh KS, Park SW, Castro A, Patel H, Blake P, Liang M, Goy A | title = Ovarian cancer biomarkers for molecular biosensors and translational medicine | journal = Expert Review of Molecular Diagnostics | volume = 10 | issue = 8 | pages = 1069–83 | date = Nov 2010 | pmid = 21080822 | doi = 10.1586/erm.10.87 }}
16. ^1 {{Citation |author1 = American Congress of Obstetricians and Gynecologists |author1-link = American Congress of Obstetricians and Gynecologists |date = |title = Five Things Physicians and Patients Should Question |publisher = American Congress of Obstetricians and Gynecologists |work = Choosing Wisely: an initiative of the ABIM Foundation |page = |url = http://www.choosingwisely.org/doctor-patient-lists/american-college-of-obstetricians-and-gynecologists/ |accessdate = August 1, 2013}}, which cites* {{cite journal | title = Screening for Ovarian Cancer: Recommendation Statement | journal = The Annals of Family Medicine | volume = 2 | issue = 3 | pages = 260–262 | year = 2004 | pmid = | pmc = | doi = 10.1370/afm.200 }}*{{citation |last1=Lin |first1=Kenneth |last2=Barton |first2=Mary B. |title=Screening for Ovarian Cancer - Evidence Update for the U.S. Preventive Services Task Force Reaffirmation Recommendation Statement |url=http://www.uspreventiveservicestaskforce.org/uspstf12/ovarian/ovarart.htm |work=AHRQ Publication No. 12-05165-EF-3 |publisher=United States Preventive Services Task Force |accessdate=30 August 2013 |date=April 2012}}* {{cite journal | vauthors = Partridge E, Kreimer AR, Greenlee RT, Williams C, Xu JL, Church TR, Kessel B, Johnson CC, Weissfeld JL, Isaacs C, Andriole GL, Ogden S, Ragard LR, Buys SS | title = Results from four rounds of ovarian cancer screening in a randomized trial | journal = Obstetrics and Gynecology | volume = 113 | issue = 4 | pages = 775–82 | date = Apr 2009 | pmid = 19305319 | pmc = 2728067 | doi = 10.1097/AOG.0b013e31819cda77 }}* {{cite journal | title = Committee Opinion No. 477: the role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer | journal = Obstetrics and Gynecology | volume = 117 | issue = 3 | pages = 742–6 | date = Mar 2011 | pmid = 21343791 | pmc = | doi = 10.1097/AOG.0b013e31821477db | author1 = American College of Obstetricians Gynecologists Committee on Gynecologic Practice }}
17. ^{{cite journal | vauthors = Gupta D, Lis CG | title = Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature | journal = Nutrition Journal | volume = 9 | issue = | pages = 69 | year = 2010 | pmid = 21176210 | pmc = 3019132 | doi = 10.1186/1475-2891-9-69 }}
18. ^{{cite journal | vauthors = Bast RC, Klug TL, St John E, Jenison E, Niloff JM, Lazarus H, Berkowitz RS, Leavitt T, Griffiths CT, Parker L, Zurawski VR, Knapp RC | title = A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer | journal = The New England Journal of Medicine | volume = 309 | issue = 15 | pages = 883–7 | date = Oct 1983 | pmid = 6310399 | doi = 10.1056/NEJM198310133091503 }}
19. ^1 {{cite journal | vauthors = Göcze P, Vahrson H | title = [Ovarian carcinoma antigen (CA 125) and ovarian cancer (clinical follow-up and prognostic studies)] | language = Hungarian | journal = Orvosi Hetilap | volume = 134 | issue = 17 | pages = 915–8 | date = Apr 1993 | pmid = 8479736 | doi = }}
20. ^1 {{cite journal | vauthors = Santillan A, Garg R, Zahurak ML, Gardner GJ, Giuntoli RL, Armstrong DK, Bristow RE | title = Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range | journal = Journal of Clinical Oncology | volume = 23 | issue = 36 | pages = 9338–43 | date = Dec 2005 | pmid = 16361633 | doi = 10.1200/JCO.2005.02.2582 }}
21. ^{{cite book |vauthors=Mais DD, Leonard GR | title = Quick Compendium Companion for Clinical Pathology | publisher = American Society for Clinical Pathology | location = Chicago | year = 2009 | edition = 2nd | pages = 352 | isbn = 978-0-89189-579-4 }}
22. ^{{cite web | url = http://www.nice.org.uk/newsroom/news/WomenShouldBeOfferedBloodTest.jsp | title = Women should be offered a blood test for ovarian cancer | date = 2011-04-27 | format = | work = NICE guidance | publisher = United Kingdom National Institute for Health and Clinical Excellence | accessdate = 2012-04-14 }}
23. ^{{cite journal | vauthors = Wang ML, Huang Q, Yang TX | title = IgE myeloma with elevated level of serum CA125 | journal = Journal of Zhejiang University. Science. B | volume = 10 | issue = 7 | pages = 559–62 | date = Jul 2009 | pmid = 19585675 | pmc = 2704975 | doi = 10.1631/jzus.B0820399 }}
24. ^{{cite journal | vauthors = Baron JA | title = Screening for cancer with molecular markers: progress comes with potential problems | journal = Nature Reviews. Cancer | volume = 12 | issue = 5 | pages = 368–71 | date = May 2012 | pmid = 22495319 | doi = 10.1038/nrc3260 | pmc=3843943}}
25. ^1 2 {{cite journal | vauthors = Fritsche HA, Bast RC | title = CA 125 in ovarian cancer: advances and controversy | journal = Clinical Chemistry | volume = 44 | issue = 7 | pages = 1379–80 | date = Jul 1998 | pmid = 9665412 | doi = }}
26. ^1 2 3 4 {{cite journal | vauthors = Nossov V, Amneus M, Su F, Lang J, Janco JM, Reddy ST, Farias-Eisner R | title = The early detection of ovarian cancer: from traditional methods to proteomics. Can we really do better than serum CA-125? | journal = American Journal of Obstetrics and Gynecology | volume = 199 | issue = 3 | pages = 215–23 | date = Sep 2008 | pmid = 18468571 | doi = 10.1016/j.ajog.2008.04.009 }}
27. ^{{cite journal | vauthors = Moss EL, Hollingworth J, Reynolds TM | title = The role of CA125 in clinical practice | journal = Journal of Clinical Pathology | volume = 58 | issue = 3 | pages = 308–12 | date = Mar 2005 | pmid = 15735166 | pmc = 1770590 | doi = 10.1136/jcp.2004.018077 }}
28. ^{{cite journal | vauthors = Osman N, O'Leary N, Mulcahy E, Barrett N, Wallis F, Hickey K, Gupta R | title = Correlation of serum CA125 with stage, grade and survival of patients with epithelial ovarian cancer at a single centre | journal = Irish Medical Journal | volume = 101 | issue = 8 | pages = 245–7 | date = Sep 2008 | pmid = 18990955 | doi = }}
29. ^{{cite journal | vauthors = Bagan P, Berna P, Assouad J, Hupertan V, Le Pimpec Barthes F, Riquet M | title = Value of cancer antigen 125 for diagnosis of pleural endometriosis in females with recurrent pneumothorax | journal = The European Respiratory Journal | volume = 31 | issue = 1 | pages = 140–2 | date = Jan 2008 | pmid = 17804443 | doi = 10.1183/09031936.00094206 }}
30. ^{{cite journal | vauthors = Sarandakou A, Protonotariou E, Rizos D | title = Tumor markers in biological fluids associated with pregnancy | journal = Critical Reviews in Clinical Laboratory Sciences | volume = 44 | issue = 2 | pages = 151–78 | year = 2007 | pmid = 17364691 | doi = 10.1080/10408360601003143 }}
31. ^{{cite journal | vauthors = Asher V, Hammond R, Duncan TJ | title = Pelvic mass associated with raised CA 125 for benign condition: a case report | journal = World Journal of Surgical Oncology | volume = 8 | issue = | pages = 28 | year = 2010 | pmid = 20398372 | pmc = 2861664 | doi = 10.1186/1477-7819-8-28 }}
32. ^{{cite journal | vauthors = Faulkner D, Meldrum C | title = Tumour markers | journal = Australian Prescriber | volume = 35 | issue = 4 | pages = 125–8 | year = 2012 | doi = 10.18773/austprescr.2012.052 }}
33. ^{{cite journal | vauthors = Ferrini R | title = Screening asymptomatic women for ovarian cancer: American College of Preventive Medicine practice policy | journal = American Journal of Preventive Medicine | volume = 13 | issue = 6 | pages = 444–6 | year = 1997 | pmid = 9415790 | doi = 10.1016/S0749-3797(18)30139-9| url = http://www.acpm.org/resource/resmgr/policy-files/polstmt_ovary.pdf }}
34. ^{{cite journal | vauthors = Rosen DG, Wang L, Atkinson JN, Yu Y, Lu KH, Diamandis EP, Hellstrom I, Mok SC, Liu J, Bast RC | title = Potential markers that complement expression of CA125 in epithelial ovarian cancer | journal = Gynecologic Oncology | volume = 99 | issue = 2 | pages = 267–77 | date = Nov 2005 | pmid = 16061277 | doi = 10.1016/j.ygyno.2005.06.040 }}
35. ^{{cite journal | vauthors = Sasaroli D, Coukos G, Scholler N | title = Beyond CA125: the coming of age of ovarian cancer biomarkers. Are we there yet? | journal = Biomarkers in Medicine | volume = 3 | issue = 3 | pages = 275–288 | date = Jun 2009 | pmid = 19684876 | pmc = 2726755 | doi = 10.2217/bmm.09.21 }}
36. ^{{cite journal | vauthors = Patankar MS, Jing Y, Morrison JC, Belisle JA, Lattanzio FA, Deng Y, Wong NK, Morris HR, Dell A, Clark GF | title = Potent suppression of natural killer cell response mediated by the ovarian tumor marker CA125 | journal = Gynecologic Oncology | volume = 99 | issue = 3 | pages = 704–13 | date = Dec 2005 | pmid = 16126266 | doi = 10.1016/j.ygyno.2005.07.030 }}
37. ^{{cite journal | vauthors = Seelenmeyer C, Wegehingel S, Lechner J, Nickel W | title = The cancer antigen CA125 represents a novel counter receptor for galectin-1 | journal = Journal of Cell Science | volume = 116 | issue = Pt 7 | pages = 1305–18 | date = Apr 2003 | pmid = 12615972 | doi = 10.1242/jcs.00312 }}
38. ^{{cite journal | vauthors = Rump A, Morikawa Y, Tanaka M, Minami S, Umesaki N, Takeuchi M, Miyajima A | title = Binding of ovarian cancer antigen CA125/MUC16 to mesothelin mediates cell adhesion | journal = The Journal of Biological Chemistry | volume = 279 | issue = 10 | pages = 9190–8 | date = March 2004 | pmid = 14676194 | doi = 10.1074/jbc.M312372200 }}
39. ^1 {{cite journal | vauthors = Gubbels JA, Belisle J, Onda M, Rancourt C, Migneault M, Ho M, Bera TK, Connor J, Sathyanarayana BK, Lee B, Pastan I, Patankar MS | title = Mesothelin-MUC16 binding is a high affinity, N-glycan dependent interaction that facilitates peritoneal metastasis of ovarian tumors | journal = Molecular Cancer | volume = 5 | issue = 1 | pages = 50 | date = October 2006 | pmid = 17067392 | pmc = 1635730 | doi = 10.1186/1476-4598-5-50 }}
40. ^{{cite journal | vauthors = Kaneko O, Gong L, Zhang J, Hansen JK, Hassan R, Lee B, Ho M | title = A binding domain on mesothelin for CA125/MUC16 | journal = The Journal of Biological Chemistry | volume = 284 | issue = 6 | pages = 3739–49 | date = February 2009 | pmid = 19075018 | pmc = 2635045 | doi = 10.1074/jbc.M806776200 }}
41. ^{{cite journal | vauthors = Xiang X, Feng M, Felder M, Connor JP, Man YG, Patankar MS, Ho M | title = HN125: A Novel Immunoadhesin Targeting MUC16 with Potential for Cancer Therapy | journal = Journal of Cancer | volume = 2 | pages = 280–91 | date = 2011 | pmid = 21611109 | pmc = 3100680 }}
42. ^{{cite journal | vauthors = Chang K, Pastan I | title = Molecular cloning of mesothelin, a differentiation antigen present on mesothelium, mesotheliomas, and ovarian cancers | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 93 | issue = 1 | pages = 136–40 | date = January 1996 | pmid = 8552591 | pmc = 40193 | doi = 10.1073/pnas.93.1.136 }}
43. ^{{cite journal | vauthors = Thériault C, Pinard M, Comamala M, Migneault M, Beaudin J, Matte I, Boivin M, Piché A, Rancourt C | title = MUC16 (CA125) regulates epithelial ovarian cancer cell growth, tumorigenesis and metastasis | journal = Gynecologic Oncology | volume = 121 | issue = 3 | pages = 434–43 | date = Jun 2011 | pmid = 21421261 | doi = 10.1016/j.ygyno.2011.02.020 }}
44. ^{{cite journal | vauthors = Boivin M, Lane D, Piché A, Rancourt C | title = CA125 (MUC16) tumor antigen selectively modulates the sensitivity of ovarian cancer cells to genotoxic drug-induced apoptosis | journal = Gynecologic Oncology | volume = 115 | issue = 3 | pages = 407–13 | date = Dec 2009 | pmid = 19747716 | doi = 10.1016/j.ygyno.2009.08.007 }}
45. ^{{cite journal | vauthors = Bast RC, Feeney M, Lazarus H, Nadler LM, Colvin RB, Knapp RC | title = Reactivity of a monoclonal antibody with human ovarian carcinoma | journal = The Journal of Clinical Investigation | volume = 68 | issue = 5 | pages = 1331–7 | date = Nov 1981 | pmid = 7028788 | pmc = 370929 | doi = 10.1172/JCI110380 }}
46. ^{{cite journal | vauthors = Schmidt C | title = CA-125: a biomarker put to the test | journal = Journal of the National Cancer Institute | volume = 103 | issue = 17 | pages = 1290–1 | date = Sep 2011 | pmid = 21852262 | pmc = | doi = 10.1093/jnci/djr344 }}

Further reading

{{refbegin|33em}}
  • {{cite journal | vauthors = Argüeso P, Guzman-Aranguez A, Mantelli F, Cao Z, Ricciuto J, Panjwani N | title = Association of cell surface mucins with galectin-3 contributes to the ocular surface epithelial barrier | journal = The Journal of Biological Chemistry | volume = 284 | issue = 34 | pages = 23037–45 | date = Aug 2009 | pmid = 19556244 | pmc = 2755710 | doi = 10.1074/jbc.M109.033332 }}
  • {{cite journal | vauthors = Dogru M, Matsumoto Y, Okada N, Igarashi A, Fukagawa K, Shimazaki J, Tsubota K, Fujishima H | title = Alterations of the ocular surface epithelial MUC16 and goblet cell MUC5AC in patients with atopic keratoconjunctivitis | journal = Allergy | volume = 63 | issue = 10 | pages = 1324–34 | date = Oct 2008 | pmid = 18782111 | doi = 10.1111/j.1398-9995.2008.01781.x }}
  • {{cite journal | vauthors = McLemore MR, Aouizerat B | title = Introducing the MUC16 gene: implications for prevention and early detection in epithelial ovarian cancer | journal = Biological Research for Nursing | volume = 6 | issue = 4 | pages = 262–7 | date = Apr 2005 | pmid = 15788735 | doi = 10.1177/1099800404274445 }}
  • {{cite journal | vauthors = Palmieri RT, Wilson MA, Iversen ES, Clyde MA, Calingaert B, Moorman PG, Poole C, Anderson AR, Anderson S, Anton-Culver H, Beesley J, Hogdall E, Brewster W, Carney ME, Chen X, Chenevix-Trench G, Chang-Claude J, Cunningham JM, Dicioccio RA, Doherty JA, Easton DF, Edlund CK, Gayther SA, Gentry-Maharaj A, Goode EL, Goodman MT, Kjaer SK, Hogdall CK, Hopkins MP, Jenison EL, Blaakaer J, Lurie G, McGuire V, Menon U, Moysich KB, Ness RB, Pearce CL, Pharoah PD, Pike MC, Ramus SJ, Rossing MA, Song H, Terada KY, Vandenberg D, Vierkant RA, Wang-Gohrke S, Webb PM, Whittemore AS, Wu AH, Ziogas A, Berchuck A, Schildkraut JM | title = Polymorphism in the IL18 gene and epithelial ovarian cancer in non-Hispanic white women | journal = Cancer Epidemiology, Biomarkers & Prevention | volume = 17 | issue = 12 | pages = 3567–72 | date = Dec 2008 | pmid = 19064572 | pmc = 2664299 | doi = 10.1158/1055-9965.EPI-08-0548 }}
  • {{cite journal | vauthors = Sangoi AR, Higgins JP, Rouse RV, Schneider AG, McKenney JK | title = Immunohistochemical comparison of MUC1, CA125, and Her2Neu in invasive micropapillary carcinoma of the urinary tract and typical invasive urothelial carcinoma with retraction artifact | journal = Modern Pathology | volume = 22 | issue = 5 | pages = 660–7 | date = May 2009 | pmid = 19270645 | doi = 10.1038/modpathol.2009.16 }}
  • {{cite journal | vauthors = Huhtinen K, Suvitie P, Hiissa J, Junnila J, Huvila J, Kujari H, Setälä M, Härkki P, Jalkanen J, Fraser J, Mäkinen J, Auranen A, Poutanen M, Perheentupa A | title = Serum HE4 concentration differentiates malignant ovarian tumours from ovarian endometriotic cysts | journal = British Journal of Cancer | volume = 100 | issue = 8 | pages = 1315–9 | date = Apr 2009 | pmid = 19337252 | pmc = 2676558 | doi = 10.1038/sj.bjc.6605011 }}
  • {{cite journal | vauthors = Bekci TT, Senol T, Maden E | title = The efficacy of serum carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3), alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels in determining the malignancy of solitary pulmonary nodules | journal = The Journal of International Medical Research | volume = 37 | issue = 2 | pages = 438–45 | year = 2009 | pmid = 19383238 | doi = 10.1177/147323000903700219 }}
  • {{cite journal | vauthors = Bjerner J, Høgetveit A, Wold Akselberg K, Vangsnes K, Paus E, Bjøro T, Børmer OP, Nustad K | title = Reference intervals for carcinoembryonic antigen (CEA), CA125, MUC1, Alfa-foeto-protein (AFP), neuron-specific enolase (NSE) and CA19.9 from the NORIP study | journal = Scandinavian Journal of Clinical and Laboratory Investigation | volume = 68 | issue = 8 | pages = 703–13 | year = 2008 | pmid = 18609108 | doi = 10.1080/00365510802126836 }}
  • {{cite journal | vauthors = Madendag Y, Col-Madendag I, Kanat-Pektas M, Danisman N | title = Predictive power of serum CA-125 and LDH in the outcome of first trimester pregnancies with human chorionic gonadotropin levels below discriminatory zone | journal = Archives of Gynecology and Obstetrics | volume = 279 | issue = 5 | pages = 661–6 | date = May 2009 | pmid = 18797897 | doi = 10.1007/s00404-008-0798-x }}
  • {{cite journal | vauthors = Wang ML, Huang Q, Yang TX | title = IgE myeloma with elevated level of serum CA125 | journal = Journal of Zhejiang University. Science. B | volume = 10 | issue = 7 | pages = 559–62 | date = Jul 2009 | pmid = 19585675 | pmc = 2704975 | doi = 10.1631/jzus.B0820399 }}
  • {{cite journal | vauthors = Camlica H, Duranyildiz D, Tas F, Yasasever V | title = Statistical interpretation of CA125 and Bcl-2 in serum of patients with late stage ovarian cancer | journal = American Journal of Clinical Oncology | volume = 31 | issue = 6 | pages = 585–8 | date = Dec 2008 | pmid = 19060592 | doi = 10.1097/COC.0b013e318174dbd2 }}
  • {{cite journal | vauthors = Caffery B, Joyce E, Heynen ML, Jones L, Ritter R, Gamache DA, Senchyna M | title = MUC16 expression in Sjogren's syndrome, KCS, and control subjects | journal = Molecular Vision | volume = 14 | issue = | pages = 2547–55 | year = 2008 | pmid = 19122828 | pmc = 2613075 | doi = }}
  • {{cite journal | vauthors = Prat A, Parera M, Adamo B, Peralta S, Perez-Benavente MA, Garcia A, Gil-Moreno A, Martinez-Palones JM, Baselga J, del Campo JM | title = Risk of recurrence during follow-up for optimally treated advanced epithelial ovarian cancer (EOC) with a low-level increase of serum CA-125 levels | journal = Annals of Oncology | volume = 20 | issue = 2 | pages = 294–7 | date = Feb 2009 | pmid = 18820245 | doi = 10.1093/annonc/mdn601 }}
  • {{cite journal | vauthors = de Larrea CF, Cibeira MT, Vallansot R, Colomo L, Bladé J | title = Increased serum tumor markers (CA125 and CA15.3) in primary plasma cell leukemia: a case report and review of the literature | journal = Clinical Lymphoma & Myeloma | volume = 8 | issue = 5 | pages = 312–4 | date = Oct 2008 | pmid = 18854288 | doi = 10.3816/CLM.2008.n.045 }}
  • {{cite journal | vauthors = Cebesoy FB, Balat O, Dikensoy E, Kalayci H, Ibar Y | title = CA-125 and CRP are elevated in preeclampsia | journal = Hypertension in Pregnancy | volume = 28 | issue = 2 | pages = 201–11 | date = May 2009 | pmid = 19437230 | doi = 10.1080/10641950802601187 }}
  • {{cite journal | vauthors = Yu B, Xu PZ, Wang QW, Zhou H, Zhou HX | title = Clinical value of tumour specific growth factor (TSGF) and carbohydrate antigen-125 (CA-125) in carcinoma of the endometrium | journal = The Journal of International Medical Research | volume = 37 | issue = 3 | pages = 878–83 | year = 2009 | pmid = 19589273 | doi = 10.1177/147323000903700333 }}
  • {{cite journal | vauthors = Kaneko O, Gong L, Zhang J, Hansen JK, Hassan R, Lee B, Ho M | title = A binding domain on mesothelin for CA125/MUC16 | journal = The Journal of Biological Chemistry | volume = 284 | issue = 6 | pages = 3739–49 | date = Feb 2009 | pmid = 19075018 | pmc = 2635045 | doi = 10.1074/jbc.M806776200 }}
  • {{cite journal | vauthors = Kouba EJ, Lentz A, Wallen EM, Pruthi RS | title = Clinical use of serum CA-125 levels in patients undergoing radical cystectomy for transitional cell carcinoma of the bladder | journal = Urologic Oncology | volume = 27 | issue = 5 | pages = 486–90 | year = 2009 | pmid = 18555706 | doi = 10.1016/j.urolonc.2008.03.019 }}
  • {{cite journal | vauthors = Samuels TL, Handler E, Syring ML, Pajewski NM, Blumin JH, Kerschner JE, Johnston N | title = Mucin gene expression in human laryngeal epithelia: effect of laryngopharyngeal reflux | journal = The Annals of Otology, Rhinology, and Laryngology | volume = 117 | issue = 9 | pages = 688–95 | date = Sep 2008 | pmid = 18834073 | doi = 10.1177/000348940811700911}}
  • {{cite journal | vauthors = De Gennaro L, Brunetti ND, Bungaro R, Montrone D, Cuculo A, Pellegrino PL, Correale M, Di Biase M | title = Carbohydrate antigen-125: additional accuracy in identifying patients at risk of acute heart failure in acute coronary syndrome | journal = Coronary Artery Disease | volume = 20 | issue = 4 | pages = 274–80 | date = Jun 2009 | pmid = 19440066 | doi = 10.1097/MCA.0b013e3283229d82 }}
{{refend}}

External links

  • CA-125 blood test urban legend at snopes.com
  • {{MeshName|CA-125+Antigen}}
  • CA-125 at Lab Tests Online
  • CA-125 analyte monograph{{Dead link|date=November 2018 |bot=InternetArchiveBot |fix-attempted=yes }} from The Association for Clinical Biochemistry and Laboratory Medicine.
  • {{UCSC gene info|MUC16}}
{{Mucoproteins}}{{Tumor markers}}

1 : Tumor markers
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