Clinical evaluation of non-operative diagnosis of endometriosis

Objective To investigate the clinical diagnostic value of non-operative method for endometriosis.Methods 179 patients scheduled to perform surgery because of mass and/or dysmenorrhea or infertility joined serum CA125 or ultrasound were prospectively studied.The sensitivity,specificity,positive predictive value,and negative predictive value either in each clinical index including dysmenorrheal,positive pelvic signs,serum CA125,ultrasound or combined clinical indexes were calculated by clinical epidemiological method.Results Any single use of clinical indexes achieved poor sensitivity and specificity.Higher sensitivity of 85.54% or specificity of 81.90% was found when combined clinical indexes were used either by parallel test or serial test of combination with any two clinical indexes.The sensitivity of dysmenorrheal,positive pelvic signs,ultrasound and serum CA125 was respectively 79.07%,67.44%,72.09% and 76.74% in adenomyosis and 73.68%,60.53%,76.32 and 71.05% in chocolate cyst.The sensitivity of the two type's endometriosis with each clinical index was higher than that in any type endometriosis excepting positive pelvic signs.Conclusion The non-operative diagnostic method for endometriosis is reliable with clinical indexes.Higher sensitivity and specificity is found with combined clinical indexes than in each clinical index.The sensitivity with each clinical index in adenomyosis is higher than that in chocolate cyst excepting ultrasound.