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

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).