Research On The Relationship And Prognosis Between Serum CA 125 Level And Light-Chain Cardiac Amyloidosis

Background:Light-chain cardiac amyloidosis(AL-CA)is a condition of systemic amyloidosis with myocardial involvement,and carbohydrate antigen 125(CA 125)is a tumor marker that is widely used in diagnosis,efficacy and prognosis evaluation of gynecological tumors,especially ovarian tumor.More and more researches have confirmed the association between CA125 and cardiovascular diseases,but there is on study has reported the relationship between CA 125 and AL-CA.Objective:The aim of this study was to investigate the relationship between CA125 and AL-CA and to explore the clinical implications of increased serum CA 125 levels in patients with AL-CA.Methods:A total of 95 AL-CA patients were enrolled in our study,and 35KU/L was used as the cut-off value of CA 125.95 AL-CA patients were divided into high serum CA 125 group(>35 KU/L)and normal serum CA 125 group(≤35 KU/L).Clinical baseline data were collected during hospitalization and all patients were followed up.Results:57(60%)patients had elevated serum CA 125 levels.The mean age was 59.7±10.0 years with 44(77.2%)males in high serum CA 125 group,and 61.8±9.6 years with 28(73.7%)males in the normal group.Patients with high CA 125 showed higher rates of polyserositis(79.3% vs.60.5%,p=0.03),higher levels of hemoglobin(117.4±21.9 vs.106.08±25.1 g/L,p=0.03),serum potassium(4.11±0.47 vs.3.97±0.40 mmol/L,p=0.049),low density lipoprotein-cholesterol(3.0±1.6 vs.2.3±1.10 mmol/L,p=0.01),and cardiac troponin T(96.0 vs.91.9 pg/m L,p=0.005).The median overall survival times for patients with high or normal serum CA125 were 5 and 25 months,respectively(p=0.045).Multivariate Cox hazard analysis showed that treatment without chemotherapy(HR 1.694,95% CI 1.121-2.562,p=0.012)and CA 125(HR 1.002,95% CI1.000-1.004,p=0.020)was correlated with high all-cause mortality.Time-dependent receiver operating characteristic(ROC)curve showed that prediction accuracy of CA 125 was not inferior to that of cardiac troponin T,NT-pro BNP and LDH based on the area under the curve.Conclusions:Serum CA 125 levels were increased in more than half of patients with AL-CA.High serum CA 125 level is associated with poor prognosis and the accuracy of predicting prognosis is not inferior to that of traditional biomarkers in AL-CA.