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:10.1097/00006254-198843040-00021 · W4248733252
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This study of 22 women undergoing hysterectomy found that preoperative serum CA-125 levels were normal in all patients with histologically verified adenomyosis, contradicting previous reports of elevated levels.

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This study investigated serum CA-125 levels in 22 women undergoing hysterectomy for benign uterine disease, with histological verification of adenomyosis in half the participants. The researchers found that preoperative CA-125 levels were normal in 91 percent of patients, including all individuals diagnosed with adenomyosis, contradicting previous reports of frequent elevation in this condition. Postoperatively, slight elevations occurred in some cases at one week but normalized by five weeks, suggesting that hysterectomy effectively resolves any associated marker increases. Relevance to endometriosis: This paper is centrally about adenomyosis and specifically addresses the diagnostic utility and post-surgical behavior of CA-125 levels in patients with this condition.

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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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endometriosisadenomyosis

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