Open Access

ARTICLE

Variant prostate carcinoma and elevated serum CA-125

Mehmet Asim Bilen¹, Adriana Reyes², Deb Bhowmick^1,3, April Maa^1,4, Robert Bast, Jr⁵, Louis L. Pisters⁶, Sue-Hwa Lin⁷, Christopher J. Logothetis¹, Shi-Ming Tu¹

1 Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
2 Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
3 Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina, USA
4 Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
5 Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
6 Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
7 Department of Translational Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Address correspondence to Dr. Shi-Ming Tu, Department of Genitourinary Medical Oncology, Box 427, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA

Canadian Journal of Urology 2014, 21(5), 7442-7448.

Abstract

Introduction: About 10% of tumors derived from nongynecologic, noncoelomic tissues react with the OC125 antibody. Some patients with advanced prostate cancer were found to have elevated serum CA-125 level.
Materials and methods: We examined the clinical history of 11 patients with castration resistant prostate cancer and an elevated serum CA-125 level. Pathological review and immunohistochemical staining were performed on tumors from eight of these patients.
Results: Patients with advanced prostate cancer and an elevated serum CA-125 level responded to androgen ablative therapy (median duration, 27 months). They were predisposed to develop persistent or recurrent urinary symptoms and visceral metastases. Eight of 11 patients had a low or undetectable serum prostate-specific antigen level (≤4 ng/mL) or an elevated serum carcinoembryonic antigen level (>6 ng/mL). In 3 of 7 patients whose specimens were available for further review, the tumors contained histologic features compatible with a diagnosis of ductal or endometrioid adenocarcinoma of the prostate.
Conclusions: Patients with prostate cancer and an elevated serum CA-125 level have unique clinical and pathologic characteristics. Some of these patients possess tumors compatible with a subtype of prostate cancer known as ductal adenocarcinoma. Additional studies need to be performed to elucidate the biologic basis of the various subtypes of prostate cancer.

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