title: Comparative study between VEGF-A and CA-125 in diagnosis and follow-up of advanced endometriosis after conservative laparoscopic surgery.
abstract: OBJECTIVE
  To evaluate the role of serum level of VEGF-A in comparison to CA-125 in diagnosis and follow-up of patients with advanced endometriosis after conservative laparoscopic surgery.
  
  
  METHODS
  A prospective randomized case-control study was performed on patients referred for laparoscopy complaining of unexplained primary infertility with or without chronic pelvic pain. Thirty patients with advanced endometriosis; stage III-IV were included (study group), another 30 women without endometriosis or any other medical conditions were settled as a control group. Pre-operative blood samples were collected from study and control cases. Post-operative blood samples were collected from 25 treated patients in the follicular phase of the third menstrual cycle; 5 cases were drop-outs. Serum level of cancer antigen-125 (CA-125) and vascular endothelial growth factor (VEGF-A) were assayed by using enzyme linked immunosorbent assay (ELISA) kit.
  
  
  RESULTS
  There was a statistically significant difference in serum CA-125 and VEGF-A level in patients with advanced endometriosis before conservative laparoscopic surgery and those without endometriosis (p < 0.001) and after conservative laparoscopic surgery (p < 0.001). High sensitivity (93.3 %), specificity (96.7 %) and accuracy (95.0 %) of VEGF-A assay than in CA-125 distinguishing between patients with endometriosis from those without endometriosis; CA-125 has 70.0 %sensitivity, 90.0 % specificity and 85.0 % accuracy. Percentage of decrease of VEGF-A level after operation was higher than that of CA-125 (45.9 vs. 25.8 %) p < 0.001, respectively.
  
  
  CONCLUSIONS
  The use of VEGF-A for diagnosis of advanced endometriosis at cut-off 680 pg/ml and for follow-up is better than CA-125.
authors.affiliation: Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
authors.forename: Mohamed L
authors.initials: ML
authors.lastname: Mohamed
authors.forename: Manal M
authors.initials: MM
authors.lastname: El Behery
authors.forename: Shymaa A E-A
authors.initials: SA
authors.lastname: Mansour
mesh_terms: D000293:Adolescent; D000328:Adult; D018394:CA-125 Antigen / Q000097:blood*; D016022:Case-Control Studies; D004715:Endometriosis / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005498:Follicular Phase / Q000097:blood; D006801:Humans; D010535:Laparoscopy; D017699:Pelvic Pain; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D018394:CA-125 Antigen; D042461:Vascular Endothelial Growth Factor A