Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2022; 10(23): 8141-8151
Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8141
Diagnostic value of elevated serum carbohydrate antigen 125 level in sarcoidosis
Qian Zhang, Xiao-Yan Jing, Xiao-Yu Yang, Zuo-Jun Xu
Qian Zhang, Xiao-Yan Jing, Xiao-Yu Yang, Zuo-Jun Xu, Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Author contributions: Zhang Q participated in study design and drafted the manuscript; Jing XY and Yang XY participated in data collection and performed the statistical analysis; Xu ZJ revised the manuscript; and All authors read and approved the final manuscript.
Supported by Municipal Natural Science Foundation of Beijing of China, No. 7212076; and National Natural Science Foundation of China (General Program), No. 82070067.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Peking Union Medical College Hospital.
Informed consent statement: Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zuo-Jun Xu, MD, PhD, Chief Doctor, Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China. xuzjdoc@163.com
Received: March 11, 2022
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
Processing time: 142 Days and 21.9 Hours
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

Abnormally elevated serum CA125 is important in the noninvasive diagnosis of sarcoidosis and strongly associated with the clinical characteristics among sarcoidosis patients.

Research perspectives

Abnormally elevated serum CA125 Level may be a potentially useful biomarker for sarcoidosis diagnosis and has an association with disease characteristics.