The Effect of Hysterectomy on Serum CA-125 Levels in Patients with Adenomyosis and Uterine Fibroids

Hannu Halila, Anne‐Maria Suikkari, Markku Seppälä
In: Obstetrical & Gynecological Survey · 1988 · vol. 43(4) , pp. 246–247 · doi:10.1097/00006254-198804000-00021 · W2002439748
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This study found that preoperative serum CA-125 levels were normal in most women with adenomyosis or uterine fibroids undergoing hysterectomy, with transient elevations postoperatively.

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This study investigated serum CA-125 levels in 22 women undergoing hysterectomy for benign uterine disease, specifically comparing those with histologically confirmed adenomyosis to those with uterine fibroids. The researchers found that preoperative CA-125 levels were normal in 91 percent of the cohort, including all patients diagnosed with adenomyosis, contradicting previous reports of frequent elevation in this condition. Postoperatively, slight transient elevations occurred in half of the patients at one week, but levels normalized or decreased by five weeks after surgery. This paper is centrally about adenomyosis — specifically evaluating whether its presence correlates with elevated preoperative CA-125 levels, which it did not find in this small sample.

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Abstract

Several reports indicate that serum levels of CA-125 are elevated in patients with advanced endometriosis, and CA-125 has been demonstrated on the cell surfaces of endometriotic lesions. In adenomyosis, the endometrium invades the myometrium. According to a previous report, elevated serum CA-125 levels are seen frequently in patients with adenomyosis. The present authors report here their findings to the contrary. Serum samples were obtained from 22 otherwise healthy women undergoing hysterectomy for benign uterine disease. The samples were collected the morning before operation and at approximately 1 and 5 weeks postoperatively. Adenomyosis was verified histologically in 11 cases. The preoperative CA-125 level was normal (less than 35 units/ml) in 20 (91 per cent) of 22 patients. All of the patients with adenomyosis had normal preoperative serum CA-125 levels. Two patients with uterine fibroids had slightly raised preoperative CA-125 levels. In both of these patients, the levels were normal 5 weeks postoperatively. In 11 (50 per cent) of 22 patients, there was a slight CA-125 elevation within normal levels 1 week postoperatively. Five weeks after hysterectomy, the serum CA-125 concentration was lower than at 1 week postoperatively (Table 1).
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The Effect of Hysterectomy on Serum CA-125 Levels in Patients with Adenomyosis and Uterine Fibroids - HANNU HALILA - ANNE-MARIA SUIKKARI - MARKKU SEPPÄLÄ Several reports indicate that serum levels of CA-125 are elevated in patients with advanced endometriosis, and CA-125 has been demonstrated on the cell surfaces of endometriotic lesions. In adenomyosis, the endometrium invades the myometrium. According to a previous report, elevated serum CA-125 levels are seen frequently in patients with adenomyosis. The present authors report here their findings to the contrary. Serum samples were obtained from 22 otherwise healthy women undergoing hysterectomy for benign uterine disease. The samples were collected the morning before operation and at approximately 1 and 5 weeks postoperatively. Adenomyosis was verified histologically in 11 cases. The preoperative CA-125 level was normal (less than 35 units/ml) in 20 (91 per cent) of 22 patients. All of the patients with adenomyosis had normal preoperative serum CA-125 levels. Two patients with uterine fibroids had slightly raised preoperative CA-125 levels. In both of these patients, the levels were normal 5 weeks postoperatively. In 11 (50 per cent) of 22 patients, there was a slight CA-125 elevation within normal levels 1 week postoperatively. Five weeks after hysterectomy, the serum CA-125 concentration was lower than at 1 week postoperatively (Table 1).

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