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

Jo Kitawaki, Kitawaki J, Ishihara H, Hiroaki Ishihara, Koshiba H, Hisato Koshiba, Miyo Kiyomizu, Kiyomizu M, Teramoto M, Mariko Teramoto, Yui Kitaoka, Kitaoka Y, Honjo H, Hideo Honjo
Human Reproduction · 2005 · vol. 20(7) , pp. 1999–2003 · doi:10.1093/humrep/deh890 · PMID:15890727 · W2166241848
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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 Adult CA-125 Antigen CA-125 Antigen Case-Control Studies Case-Control Studies Endometriosis Endometriosis Female Female Humans Humans Laparoscopy Laparoscopy Laparotomy Laparotomy Leiomyoma

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (23)

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