title: Is the measurement of placental protein-14 and CA-125 in plasma and uterine flushings useful in the evaluation of peri-menopausal and post-menopausal bleeding?
abstract: In this prospective study, we examined the possible diagnostic value of the measurement of two endometrial proteins, placental protein-14 (PP14) and CA-125, in the evaluation of pre- and post-menopausal bleeding. Concentrations of these two proteins were measured in plasma and uterine flushings obtained from 139 pre- and post-menopausal women with bleeding problems, and 26 normal post-menopausal control women without bleeding. Endometrial biopsy samples were also obtained for histological study. Concentrations of PP14 in both the plasma and uterine flushings in post-menopausal women were significantly lower (P < 0.001) than those of control pre-menopausal women. In post-menopausal women, the concentrations of PP14 (mean +/- SEM) in both plasma and flushing were significantly higher (P < 0.001) in women with endometrial adenocarcinoma (46.9+/-7.5 ng/ml plasma; 3350+/-1711 ng/ml flushing) than in the controls (7.6+/-1.3 ng/ml plasma; 125+/-27 ng/ml flushing) or in women with post-menopausal bleeding and atrophic endometrium (20.4+/-2.1 ng/ml plasma; 453+/-167 ng/ml flushing). In contrast CA-125 concentrations in plasma and flushings were similar in post-menopausal and pre-menopausal women. Plasma concentrations of CA-125 were higher in post-menopausal women with adenocarcinoma (29.1+/-7.4 IU/ml) than in those with post-menopausal bleeding and atrophic endometrium (21.8+/-2 IU/ml) (P < 0.05) or control post-menopausal subjects (16.1+/-2.1 IU/ml) (P < 0.01). CA-125 concentrations in uterine flushings were not significantly different in any group of post-menopausal women. The results show that concentrations of PP14 are correlated more strongly to endometrial histopathology than those of CA-125 in pre- and post-menopausal women. Elevated PP14 concentrations are also associated with the presence of endometrial adenocarcinoma and may have a potential to be used as a marker for this disease.
authors.affiliation: Biomedical Research Unit, Jessop Hospital for Women, Sheffield, UK.
authors.forename: T C
authors.initials: TC
authors.lastname: Li
authors.forename: M A
authors.initials: MA
authors.lastname: Okon
authors.forename: C F
authors.initials: CF
authors.lastname: Dalton
authors.forename: M
authors.initials: M
authors.lastname: Heatley
authors.forename: S M
authors.initials: SM
authors.lastname: Laird
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis / Q000378:metabolism; D000328:Adult; D000368:Aged; D001284:Atrophy; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism; D018394:CA-125 Antigen / Q000097:blood* / Q000378:metabolism*; D016889:Endometrial Neoplasms / Q000097:blood / Q000175:diagnosis / Q000378:metabolism; D004717:Endometrium / Q000473:pathology; D005260:Female; D000071816:Glycodelin; D006023:Glycoproteins / Q000097:blood* / Q000378:metabolism*; D006801:Humans; D008593:Menopause / Q000276:immunology / Q000378:metabolism; D008875:Middle Aged; D011257:Pregnancy Proteins / Q000097:blood* / Q000378:metabolism*; D011446:Prospective Studies; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism*; D014599:Uterus / Q000276:immunology / Q000378:metabolism* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D000071816:Glycodelin; D006023:Glycoproteins; C045246:PAEP protein, human; D011257:Pregnancy Proteins