The Open Public Health Journal

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

Mojtaba Ahmadinejad1, Seyed A. Hashemi2, Alireza Shirzadi1, 3, Ali Soltanian1, Jafar Ashrafi2, Kourosh Kabir4, Mahla Alizadeh5, *
1 Department of Surgery, Faculty of Medicine,Alborz University of Medical Sciences, Karaj, Iran
2 Department of Pathology, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
3 Non- Communicable Disease Research Center, Alborz University of Medical Sciences, Karaj, Iran
4 Department of Community Medicine and Epidemiology, School of Medicine, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
5 Student of Research Committee, Alborz University of Medical Sciences, Karaj, Iran



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.

Keywords: Conventional diagnosis, Acute appendicitis, CA-125, Cancer antigen, Pain, Anorexia.

Article Information

Identifiers and Pagination:

Year: 2021
Volume: 14
First Page: 162
Last Page: 167
Publisher Id: TOPHJ-14-162
DOI: 10.2174/1874944502114010162

Article History:

Received Date: 26/8/2020
Revision Received Date: 15/1/2021
Acceptance Date: 8/2/2021
Electronic publication date: 19/4/2021
Collection year: 2021

© 2021 Ahmadinejad et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Alborz University of Medical Sciences, Karaj, Iran; E-mail:

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