Association of CA 125 with Degree of Fibrosis in Chronic Liver Disease with Portal Hypertension

Abstract

Objective: To determine the association between serum CA-125 levels and degree of fibrosis in chronic liver disease with portal hypertension. Methodology: This study was conducted at Mayo Hospital Lahore. A total of 63 patients with liver cirrhosis were enrolled, demographic, clinical and laboratory parameters were documented. Modified FIB-4 index was calculated and value of 3 or more was defined as advanced liver cirrhosis. Receiver Operating Characteristic (ROC) curve was applied to calculate cut off value for CA-125 as 50 IU/L. Pearson correlation and linear regression analysis were applied to determine the association between CA-125 and modified fib -4 index. Results: Sixty three patients were enrolled. Mean age was 52.047±12.78. Female patients were 22(34.9%) and male patients were 41(65.1%). Regarding the clinical features, 8(12.7%) patients had jaundice, 38(60.3%) had ascites , 61(96.8%) had splenomegaly ,58(92.1%) had history of upper gastrointestinal bleed while 12(19%) had history of hepatic encephalopathy. Mean value of Modified fib-4score was 4.75±2.89SD, 43(67.2%) had value above cutoff of 3. Total of 38(60.3%) had CA-125 value above the cutoff level of 50 IU/L. CA-125 value above 50 IU/L has 63% sensitivity and 70% specificity in predicting advanced liver fibrosis and this association was statistically significant. (p value 0.024) . Conclusion: Serum CA-125 level above 50 IU/L is associated with presence of significant liver fibrosis.