Effect of obesity-related plasma hemodilution on serum tumor marker concentration in women

We determined to investigate the effect of plasma hemodilution on tumor marker concentration in obese women.

We collected the data for tumor markers (cancer-associated antigen 125 [CA125], carbohydrate antigen 19-9 [CA19-9], carcinoembryonic antigen [CEA] and α-fetoprotein) from 6917 healthy women who visited the health promotion center at the Chung-Ang University Hospital from 2003 to 2011. We used multivariate linear regression analysis and χ(2) -test for linear-by-linear association adjusting for age, alanine aminotransferase and creatinine to determine the association between the serum tumor marker concentrations, plasma volume, tumor marker mass, and body mass index (BMI).

Higher BMI was significantly associated with higher plasma volume (P < 0.001 for trend). The lower concentrations of CA125 and CA19-9 were significantly associated with increasing BMI (P < 0.001). Serum concentration and mass of CEA and α-fetoprotein were increased with higher BMI in obese women (P < 0.001). CEA in women had the opposite result to that in men due to visceral fat in women.

This study shows that we should consider the hemodilution effect in Asian obese women when interpreting serum tumor marker concentration in cancer screening.