CA-125 which is a glycoprotein with a molecular weight of approximately 200,000 daltons is a cellular antigen detected in many patients with ovarian cancer, but it has also been detected in pattents with endometriosis. The purpose of this study
is
to
determine the efficacy of CA-125 measurements as a screening procedure and management for endometriosis. We evaluated CA-125 in the serum of women with various stages of endometriosis and of control subjects. A total of 136 women with no systemic
illness who underwent pelviscopic operation between April, 1993 and June, 1995 were enrolled in the study.
Their ages ranged from 21 to 45 years, with a mean age of 32.85±6.88 years. Indications for pelviscopy included pelvic mass(n=68, 50.0%), pelvic pain(n=28, 20.6%), dysmenorrhea(n=18, 13.2%), infertility(n=16, 11.8%), and vaginal bleeding(n=6,
4.4%).
Preoperative CA-125 levels were drawn from patients before they underwent pelviscopy during the mild-follicular phase of menstrual cycle. CA-125 levels were measured by radioimmunoassay(RIA). Endometriosis was diagnosed by visual findings at
pelviscopy
and biopsy. In 35.4% of patients, a biopsy confirmed the diagnosis.
The stge of endometriosis was categorized according to The American Fertility Society Classification.
@ES The results were as follows.
@EN Between the endometriosis groups and control groups, there was significant difference in the mean serum CA-125 levels(p<0.05). The patients with stage I and II endometriosis had serum CA-125 levels not significantly higher than control
patients,
whereas those with stage III and IV endometriosis presented significantly higher levels than in stage I and II or control patients(p<0.05). the sensitivity of serum CA-125 measurements in the diagnosis of endometriosis was 58.3%, the specificity
was
100% with a cutoff level of 35U/ml, whereas the sensitivity was 89.6%, the specificity was 40% with a cutoff level of 16 U/ml.
It is concluded that the serum CA-125 is useful for evaluation of advanced endometriosis (stage III, IV), not useful for minimal endometriosis(stage I, II).
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