What is the role of serum CA 125 testing in the workup of pelvic masses?

Updated: Jan 10, 2020
  • Author: Gentry George T King, MD; Chief Editor: Eric B Staros, MD  more...
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Owing to the heterogeneity of its distribution, an elevated CA 125 value must be interpreted in the context of the clinical scenario and indication for which it is being tested.

There are 5 major scenarios in which testing CA 125 is useful, discussed below.

Adjunct in the discrimination of pelvic masses

Elevations in CA 125 levels are used as an adjunct to aid in differentiation of malignant from benign pelvic masses detected with clinical examination or imaging. [4] This is particularly useful in postmenopausal women, in whom confounding variables from benign and physiologic conditions are absent or infrequent. CA 125 can be used to calculate a risk of malignancy index (RMI), which is used to form the basis of algorithms in the management of pelvic masses in the United Kingdom. [7]

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