Usefulness and limits of CA-125 in diagnosis of endometriosis without associated ovarian endometriomas

Jo Kitawaki, Hiroaki Ishihara, Hisato Koshiba, Miyo Kiyomizu, Mariko Teramoto, Yui Kitaoka, Hideo Honjo
Human Reproduction · 2005 · vol. 20(7) , pp. 1999–2003 · doi:10.1093/humrep/deh890 · PMID:15890727 · W2166241848
article OA: bronze CC0 ⤵ 78 in-corpus citations
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CA-125 demonstrates limited diagnostic accuracy for endometriosis without endometriomas, but using cutoff values of 20 and 30 U/mL improves performance during initial screenings.

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Abstract

BACKGROUND: The aim of this study was to evaluate the diagnostic significance of CA-125 for endometriosis without ovarian endometriomas. METHODS: Preoperative serum CA-125 levels were measured in 775 consecutive women diagnosed by laparoscopy or laparotomy with endometriosis, adenomyosis, leiomyomas, or normal pelvis. RESULTS: Receiver operating characteristic curve analysis revealed that the area under the curve for endometriosis without endometriomas was 0.788, significantly smaller than that for endometriosis with endometriomas (0.935, P < 0.05). In diagnosis of endometriosis without endometriomas, both the maximal accuracy of 78.8% and the maximal diagnostic value of 61.2% were obtained at the cutoff value of 20 U/mL. Negative predictive value was 78.0% at the cutoff value of 20 U/mL, whereas positive predictive value was 92.9% at the cutoff value of 30 U/mL. This range is clearly superior to the empirical single cutoff of 35 U/mL. CONCLUSIONS: In the diagnosis of endometriosis without endometriomas, combined use of two cutoff values for CA-125, 20 and 30 U/mL, provides improved diagnostic performance. However, the accuracy of using only CA-125 testing for diagnosis is still limited. Serum CA-125 testing can be done during initial screenings of women with possible endometriosis.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

CA-125 Antigen Endometriosis Endometriosis Adult CA-125 Antigen Case-Control Studies Endometriosis Female Humans Laparoscopy Laparotomy Leiomyoma Leiomyoma Leiomyoma Ovarian Diseases Ovarian Diseases Ovarian Diseases Uterine Neoplasms Uterine Neoplasms Uterine Neoplasms

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