Evaluation of CA-125 Biomarker in Acute Appendicitis Patients: Correlation with Clinical Symptoms and Lab Results

The aim of this study is to evaluate the diagnostic significance of CA 125 in Acute Appendicitis (AA) along with the changes in its levels about clinical symptoms and lab findings.

Patients referred at the emergency department of Madani hospital with the suspicion of AA and right iliac fossa pain were enrolled in this study. Preoperative CA 125 levels along with C-reactive Protein (CRP) and complete blood count were obtained. Lab findings, signs and symptoms were recorded for all the patients. Statistical analysis was conducted based on CA 125 < 16.4 U/mL and ≥ 16.4 U/mL using the logistic regression model, where variables such as fever, anorexia, CRP and Erythrocyte Sedimentation Rate (ESR) were added to the model.

Of 207 patients with the mean age of 26.55 ± 0.967 years, 48.8% of them were males and 51.20% were females. 122 of the total patients had CA 125 ≥ 16.4 U/mL. Anorexia was significantly associated with increased levels of CA 125. CA 125 was 2.14 times higher in patients presenting anorexia. However, ESR, CRP and fever were not associated with the elevation of CA 125. Based on the contour plot, it was deduced that leukocytosis at its lowest and erythrocyte sedimentation rate at its highest levels is associated with the maximum concentration of serum CA 125.

Based on the findings from this study, CA 125 cannot be considered as a reliable diagnostic variable for acute appendicitis. Levels of CA 125 may vary with the severity of AA.