Serum ca 125 levels before, during, after treatment for endometriosis

Gülnur Özakşit, Çağlar Tunçay, Neslihan Çiçek, Elif Nazli Kuscu, Babür Kaleli̇, Sertaç Batıoğlu, Oya Gökmen
1995 · W2994905279
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This study evaluated serum CA 125 levels in 66 patients with endometriosis who underwent a six-month course of gonadotropin-releasing hormone agonist therapy. The researchers measured these biomarkers before treatment, during the intervention, and after cessation to assess their correlation with disease severity and recurrence. Results indicated that while CA 125 levels decreased significantly during treatment and returned to normal ranges, elevated levels post-treatment had a low positive predictive value for predicting recurrence despite moderate sensitivity and specificity. This paper is centrally about endometriosis — specifically using CA 125 as a biomarker to monitor treatment efficacy and predict disease recurrence following GnRH agonist therapy.

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Abstract

The levels of CA 125 in the serum was evaluated in 66 patients with endometriosis diagnosed and staged according to the revised American Fertility Society (AFS) classification via laparoscopy. The patients received a 6 month course of gonadotropin-releasing hormone (GnRH) agonist. Serum CA 125 levels were measured before, during (3 months and 6 months after the initiation of therapy) and 6 months after cessation of the medication. Patients with minimal and mild endometriosis had mean pre-treatment values significantly higher than control subjects in the luteal phase of the cycle or postmenopausal women (p<0.05) but the overall mean value was still below 35 U/ml. In contrast 80.7% of patients with moderate or severe endometriosis had levels in excess of 35 U/ml and the mean values for these groups were significantly elevated (p<0.005). Levels of CA 125 fell to those found in normal controls, during treatment, but rose again following cessation of the treatment. Nine of 19 subjects whose follow-up values of CA 125 exceeded 35 U/ml had a proven recurrence of endometriosis, while only 3 of 47 patients with values less than 35 U/ml had laparoscopically proven persistance or recurrence. The sensitivity and spesificity of CA 125 were 75% and 83.3% respectively and positive predictive value (PPV) was 46.36% as a predictor value of the recurrence.The data suggest that CA 125 levels may be a reliable indicator for monitoring the efficacy of GnRH agonist treatment of endometriosis, but its predictor value of recurrence is low.
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Abstract

The levels of CA 125 in the serum was evaluated in 66 patients with endometriosis diagnosed and staged according to the revised American Fertility Society (AFS) classification via laparoscopy. The patients received a 6 month course of gonadotropin-releasing hormone (GnRH) agonist. Serum CA 125 levels were measured before, during (3 months and 6 months after the initiation of therapy) and 6 months after cessation of the medication. Patients with minimal and mild endometriosis had mean pre-treatment values significantly higher than control subjects in the luteal phase of the cycle or postmenopausal women (p<0.05) but the overall mean value was still below 35 U/ml. In contrast 80.7% of patients with moderate or severe endometriosis had levels in excess of 35 U/ml and the mean values for these groups were significantly elevated (p<0.005). Levels of CA 125 fell to those found in normal controls, during treatment, but rose again following cessation of the treatment. Nine of 19 subjects whose follow-up values of CA 125 exceeded 35 U/ml had a proven recurrence of endometriosis, while only 3 of 47 patients with values less than 35 U/ml had laparoscopically proven persistance or recurrence. The sensitivity and spesificity of CA 125 were 75% and 83.3% respectively and positive predictive value (PPV) was 46.36% as a predictor value of the recurrence. The data suggest that CA 125 levels may be a reliable indicator for monitoring the efficacy of GnRH agonist treatment of endometriosis, but its predictor value of recurrence is low.

Keywords

References - Kabawat SE, Bast RC, Bhan AK, Welch WR, Knapp RC, Colvin RB. Tissue distribution of a coelomic- epithelium related antigen recognized by the monoclonal antibody OC 125. Int J Gynecol Pathol 1983;2:275-285. Details Primary Language English Subjects Clinical Sciences Journal Section Research Article Authors G. Özakşit This is me Türkiye T. Çağlar This is me Türkiye N. Çiçek This is me Türkiye E. Kuşçu This is me Türkiye B. Kaleli This is me Türkiye S. Batıoğlu This is me Türkiye O. Gökmen This is me Türkiye Publication Date July 1, 1995 Submission Date November 10, 2016 Acceptance Date May 1, 1995 Published in Issue Year 1995 Volume: 8 Number: 3

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