Usefulness of CA125 in the differential diagnosis of uterine adenomyosis and myoma

Kicheol Kil, Kil K, Jae‐Eun Chung, Chung JE, Jae-Eun Chung, Pak HJ, Ho Jeong Pak, Jeung IC, In-Cheul Jeung, Kim JH, Jang Heub Kim, Jo HH, Hyun Hee Jo, Kim MR, Mee-Ran Kim, Mee‐Ran Kim
European journal of obstetrics, gynecology, and reproductive biology · 2014 · vol. 185 , pp. 131–135 · doi:10.1016/j.ejogrb.2014.12.008 · PMID:25577553 · W2142843254
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This study investigated the utility of the CA125 biomarker in distinguishing between uterine adenomyosis and uterine myoma to aid in their differential diagnosis.

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Abstract

ObjectivesTo evaluate the usefulness of CA125 levels in the differential diagnosis of adenomyosis and myoma. This has been addressed by few, if any, previous studies.Study designPreoperative serum CA125 levels were measured in 2149 women who were diagnosed at total hysterectomy as having adenomyosis, myoma, endometriosis, and/or normal pelvis. Their medical records were retrieved and reviewed.ResultsThe mean serum CA125 level in the adenomyosis patients was significantly greater than that in the patients diagnosed with myoma (65.21±96.60 U/mL vs.12.86±14.23 U/mL, respectively; P<0.001). In the differential diagnosis of adenomyosis and myoma, the cut-off serum CA125 level with the highest accuracy (78.8%) and highest diagnostic value (61.2%) was 19 U/mL. Using this cut-off value, the negative predictive value was 69.5%, and the positive predictive value was 76.5%. These results are clearly superior to those of the empirical single cut-off value of 35 U/mL. Receiver operating characteristic curve analysis revealed the area under the curve for differentiating adenomyosis from myoma was 0.776, indicating good diagnostic performance.ConclusionIn the differential diagnosis of adenomyosis and myoma, cut-off values for CA125, particularly the cut-off value of 19 U/mL, provide improved diagnostic performance. Serum CA125 testing can be performed during the initial screening of women with possible adenomyosis to differentiate this condition from myoma, although the diagnostic accuracy of using CA125 testing alone is limited.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis CA-125 Antigen Leiomyoma Membrane Proteins Uterine Neoplasms Adenomyosis Adenomyosis Adult Biomarkers Biomarkers CA-125 Antigen Diagnosis, Differential Female Humans Leiomyoma Leiomyoma Membrane Proteins Middle Aged Retrospective Studies ROC Curve

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