Technical evaluation of three second generation CA 125 assays

The analytical performance of five CA 125 assays was studied using samples from apparently healthy women (n = 28) and from a group of patients with gynaecological malignancies (n = 260). Investigations were carried out on two homologous sandwich assays using the monoclonal antibody OC 125 (LIA-mat I and IRMA-mat I) and three heterologous assays using the monoclonal antibodies OC 125 and M11, both directed against the carcinoantigen CA 125 (LIA-mat CA 125 II, IRMA-mat CA 125 II, Centocor CA 125 II). The precision of the LIA-mat CA 125 II was better than that of the previously used LIA-mat I, the intra-assay coefficients of variation being 6.5% and 11.6% respectively. Using the new generation CA 125 II assays, only 0.5% of the duplicate measurements had to be rejected. The inter-assay coefficient of variation of the automated LIA-mat CA 125 II ranged from 7.1% to 11.2% while the IRMA-mat CA 125 II inter-assay CV ranged from 11.6% to 13.9%. Serum EDTA or heparin plasma did not give significantly different results. A carry-over of 0.02% was observed using the LIA-mat S 300 system. A high dose hook effect may be observed with concentrations over 20000 kU/l. All assays showed excellent linearity, and there was a good correlation between the assays.