Measurement of CEA, TPA, Neopterin, CA125, CA153 and CA199 in Sera of Pregnant Women, Umbilical Cord Blood and Amniotic FluidLellé R.J. · Henkel E. · Leinemann D. · Goeschen K.
aDepartment of Obstetrics and Gynecology (Director: Prof. J. Schneider) and bDepartment of Clinical Chemistry (Director: Prof. A. Delbrück), Medical School Hannover, FRG
The following tumor markers were determined in body fluids associated with pregnancy: carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), neopterin, CA125, CA153 and CA199. CEA levels (cut-off 5.0 ng/ml) were not elevated during gestation, whereas TPA was above cut-off (85 U/l) in 98 out of 107 cases (range 40–408 U/l). TPA was significantly higher during the 3rd trimester of pregnancy than during the 1st and 2nd trimesters. 38.3% of CA125 measurements were slightly above the chosen cut-off of 35 U/ml, and the mean concentration was 33.5 ± 16.2 U/ml. During delivery, 14 out of 21 values (67%) were elevated. Only 9.4% of CA153 values were elevated. CA199 and neopterin were also hardly ever above cut-off. In general, there was a wide scattering of individual values. With the exception of CA153 (neopterin not determined), high concentrations of CEA (maximum: 207 ng/ml), TPA (maximum: 1,565 U/ml), CA125 (maximum: 2,371 U/ml) and also CA199 (maximum: 1,533 U/ml) were found in amniotic fluid. The distribution in mixed cord blood was similar but with more moderate elevations and a lower incidence of levels above cut-off. Thus, none of these antigens is tumor specific. The term ‘tumor-associated antigen’ instead of ‘tumor marker’ is more appropriate. CEA, TPA, CA125 and CA199, but not CA153, are oncofetal antigens. Thus, if a pregnant woman has cancer or is followed up after malignant disease, the use of CEA, CA199 and CA153 can be recommended. TPA will yield a high percentage of false-positive values, whereas a higher cut-off for the CA125 assay in pregnancy (e.g. 90 U/ml) is recommended.