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

Abstract

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

Methods: 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).

Results: 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.

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

Keywords: alpha-fetoprotein; body mass index; cancer-associated antigen 125; carbohydrate antigen 19-9; carcinoembryonic antigen; hemodilution.