Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8141
Peer-review started: March 11, 2022
First decision: May 11, 2022
Revised: May 21, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: August 16, 2022
Sarcoidosis is a multisystem disorder with unknown etiology that predominantly affects the lungs and intrathoracic lymph nodes. At present, diagnostic biomarkers for sarcoidosis remain controversial. Carbohydrate antigen (CA) 125 is an O-glycosylated protein of the mucin family that serves a protective function in the mucus barrier on the surfaces of epithelial cells and has a potential role in the inflammatory pathogenesis of sarcoidosis.
CA125 is a tumor marker for many cancers; however, elevated CA125 is found in the sera of patients afflicted with many other diseases. The expression levels of CA125 and their clinical significance are still unknown for sarcoidosis patients.
The aim of this study was to assess the applicability of CA125 for sarcoidosis diagnosis and analyze the association between CA125 and clinical characteristics of sarcoidosis patients.
In this study, serum CA125 Level was measured by an enzyme-linked immunosorbent assay in 108 consecutive sarcoidosis patients treated between June 2016 to December 2020 (31 males, 77 females; age at diagnosis 49.69 ± 9.10 years) and compared with that in 112 healthy subjects. Data on C-reactive protein level, erythrocyte sedimentation rate, and angiotensin-converting enzyme level were also collected. The association of serum CA125 levels with clinical, radiological, and respiratory functional characteristics was analyzed between sarcoidosis patient groups with CA125 ≤ 35 U/mL or CA125 > 35 U/mL.
The authors found that serum CA125 levels were higher in sarcoidosis patients compared to healthy controls (median: 44.78 U/mL vs 19.11 U/mL, P < 0.001). The area under the receiver operator characteristic curve was 0.9833 (95%CI: 0.9717-0.9949), and the best cutoff point was 32.33 U/mL. The elevated serum CA125 was notably associated with FVC % predicted and neutrophil-to-lymphocyte ratio (P = 0.043 and P = 0.038, respectively) of the sarcoidosis patients. Multivariate analysis revealed that forced vital capacity % predicted was a statistically significant predictor of elevated serum CA125. Also, our research revealed that compared to patients with Stage I radiology classification, sarcoidosis patients with Stages II and III showed higher concentrations of serum CA125.
Abnormally elevated serum CA125 is important in the noninvasive diagnosis of sarcoidosis and strongly associated with the clinical characteristics among sarcoidosis patients.
Abnormally elevated serum CA125 Level may be a potentially useful biomarker for sarcoidosis diagnosis and has an association with disease characteristics.