Serum CA-125 concentration in endometriosis patients: role of pelvic and peritoneal irritation.
Serum CA-125 concentrations were investigated preoperatively in 91 consecutive women undergoing laparoscopy for infertility, pelvic pain and/or annexial cysts. The presence and extent of endometriosis were carefully assessed, including the American Fertility Society stage of disease, and implant and adhesion scores. Postoperative CA-125 measurements were obtained in 32 of 53 endometriosis patients and evaluated with respect to clinical evolution of the disease. Serum levels of CA-125 were significantly increased in patients with endometriosis (46.5 +/- 39.5 vs. 13.5 +/- 7.3 U/ml in controls, p < 0.001) and correlated with the severity of disease. A positive correlation (r = 0.7, p < 0.001) was observed between adhesion score and CA-125 levels, while the relationship with implant score was not significant (r = 0.3, p = 0.07). CA-125 level was also significantly increased in women with peritoneal endometriosis (70.7 +/- 47.3 vs. 33.5 +/- 25.6 U/ml for those with ovarian endometriosis), and in these patients the post-operative CA-125 level was significantly related to the clinical evolution of the disease, being higher in patients whose disease recurred compared to those with negative follow-up, irrespective of the adhesion score. We conclude that in endometriosis patients, serum CA-125 level is directly related to the adhesion score and peritoneal involvement, suggesting a central role of pelvic and peritoneal irritation in the increased level of this serum marker.
Garzetti
G G
GG
Institute of Obstetrics and Gynecology, Ancona University, Italy.
Ciavattini
A
A
Tranquilli
A L
AL
Arduini
D
D
Romanini
C
C
D000293:Adolescent; D000328:Adult; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D010064:Embryo Implantation / Q000502:physiology; D004715:Endometriosis / Q000097:blood* / Q000601:surgery; D005260:Female; D005298:Fertility / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010049:Ovarian Diseases / Q000503:physiopathology; D010053:Ovary / Q000503:physiopathology; D017699:Pelvic Pain / Q000503:physiopathology* / Q000601:surgery; D010538:Peritonitis / Q000503:physiopathology* / Q000601:surgery; D000267:Tissue Adhesions / Q000503:physiopathology
D015295:Antigens, Tumor-Associated, Carbohydrate; D015415:Biomarkers