On the origin and significance of serum CA-125 concentrations in 97 patients with endometriosis before, during, and after buserelin acetate, nafarelin, or danazol.
OBJECTIVE
To further elucidate the origin and significance of serum CA-125 in pelvic endometriosis.


METHODS
Retrospective.


METHODS
Ninety-seven women with endometriosis who participated in two trials: (1) open-label study on buserelin acetate (n = 51) and (2) comparative, placebo-controlled study on nafarelin (n = 31) versus danazol (n = 15) (2:1 ratio).


METHODS
(1) Buserelin acetate 900 micrograms/d intranasally (IN); (2) nafarelin 400 micrograms/d IN versus danazol 400 mg/d orally during 6 months.


METHODS
Serum CA-125 and estradiol concentrations; severity of endometriosis-related symptoms; scores according to The American Fertility Society (AFS) classification for endometriosis and/or adhesions (before and on last day of therapy).


RESULTS
Menstruation and adhesions appeared major factors influencing pretreatment serum CA-125 concentrations. Compared with nonmenstruating women without adhesions, both menses and adhesions induced a slight increase tending to significancy, whereas the elevating effect of adhesions and menses together was highly significant and more than expected. All three treatment regimens reduced CA-125 concentrations to the same extent; cessation of therapy was followed by restoration to pretreatment concentrations. Of the AFS scores for implants and/or adhesions, only pretreatment scores for adhesions correlated significantly with CA-125 concentrations. Severity scores for endometriosis-related complaints did not correlate.


CONCLUSIONS
The findings indicate that adhesions play a major role in the presence of CA-125 in the systemic circulation and suggest that reductions of serum CA-125 concentrations during gonadotropin-releasing hormone agonist and danazol therapy are hormonally determined.
Franssen
A M
AM
Department of Obstetrics and Gynecology, Sint Radboud University Hospital, Nijmegen, The Netherlands.
van der Heijden
P F
PF
Thomas
C M
CM
Doesburg
W H
WH
Willemsen
W N
WN
Rolland
R
R
D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis*; D002064:Buserelin / Q000627:therapeutic use*; D003613:Danazol / Q000627:therapeutic use*; D004715:Endometriosis / Q000097:blood* / Q000145:classification / Q000188:drug therapy; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008597:Menstrual Cycle; D017274:Nafarelin; D009994:Osmolar Concentration; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000097:blood / Q000150:complications
D015295:Antigens, Tumor-Associated, Carbohydrate; D017274:Nafarelin; D007987:Gonadotropin-Releasing Hormone; D003613:Danazol; D002064:Buserelin