Measurement of tumor markers in chronic hemodialysis patients

Tumor markers are widely used for screening certain tumors, however, their use in chronic hemodialysis (HD) patients in hemodialysis has been a controversial issue. To determine the reliability of the tumor markers, CA 15-3, CA 19-9, CA 125, alpha-fetoprotein and carcinoembryonic antigen (CEA), in chronic HD patients, and the impact of active hepatitis C on the variation of tumor markers values, we studied 30 patients (16 men and 14 women) aged from 40 to 78 years old (mean age: 54 + or - 5 years), on intermittent hemodialysis (with a mean duration of 10.5 years), and clinically free from neoplastic disease. The control group included 30 healthy volunteers. All subjects were of Greek origin and residents of the Korinthos region. The tumor markers were measured once in the control group and before and afterwards the hemodialysis, in the study group. Alpha fetoprotein was within normal limits in all the study patients, CA 125 was slightly increased in one (3.3%) patient, CA 15-3 levels were twice normal in 4 (13%) patients, CA 19-9 levels were twice normal in 5 (16%) patients, and CEA levels were twice normal in 4(13%) patients. More than half (7/13) of anti HCV positive and all Australian antigen positive patients had abnormal serum levels of CA 15-3 and CA 125 after hemodialysis treatment. We conclude that measurement of some tumor markers such as alfa-fetoprotein may be beneficial in HD patients. However, the elevated levels of other markers including CA 15-3 and CA 125 are not specific for neoplasms and related to active hepatitis C.