Diagnostic accuracy of cancer antigen 125 for endometriosis: a systematic review and meta‐analysis

Martin Hirsch, M Hirsch, James MN Duffy, Jmn Duffy, CJ Davis, C J Davis, Nieves Plana, M Nieves Plana, Khalid S. Khan, K S Khan, International Collaboration to Harmonise Outcomes and Measures for Endometriosis
BJOG: An International Journal of Obstetrics & Gynaecology · 2016 · vol. 123(11) , pp. 1761–1768 · doi:10.1111/1471-0528.14055 · PMID:27173590 · W2370846123
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This systematic review and meta-analysis found that serum CA 125 has 93% specificity and 52% sensitivity for diagnosing endometriosis, performing better for moderate/severe disease.

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Abstract

BACKGROUND: The development of a non-invasive and accurate diagnostic biomarker for endometriosis is urgently needed. OBJECTIVE: Evaluate the diagnostic accuracy of serum cancer antigen 125 (CA 125) for endometriosis. SEARCH STRATEGY: We searched EMBASE, MEDLINE, and Web of Science from inception to January 2016. SELECTION CRITERIA: Diagnostic accuracy studies of serum CA 125 (index test) for histologically confirmed endometriosis (reference standard) were included. DATA COLLECTION AND ANALYSIS: Two authors independently selected trials, extracted study characteristics and data. Methodological quality was assessed using Quality Assessment of Comparative Diagnostic Accuracy Studies (QUADAS-2) checklist. MAIN RESULTS: Twenty-two studies (16 cohort, six case-control), 3626 participants, were identified. Bivariate hierarchical models were used to pool accuracy data of 14 studies (2920 participants) using CA 125 ≥ 30 units/ml. Pooled specificity was 93% (95% CI 89-95%) and sensitivity 52% (95% CI 38-66%). CA 125 was significantly more sensitive for the diagnosis of moderate or severe endometriosis compared with minimal disease (63%, 95% CI 47-77% versus 24%, 95%CI 19-32%, P-value = 0.001). CONCLUSIONS: CA 125 performs well as a rule-in test facilitating expedited diagnosis and ensuring investigation and treatment can be confidently tailored for the management of endometriosis. Unfortunately, a negative test, CA 125 < 30 units/ml, is unable to rule out endometriosis. TWEETABLE ABSTRACT: Blood test CA 125: a rule-in test for the diagnosis of women presenting with symptoms of endometriosis.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

CA-125 Antigen Endometriosis Membrane Proteins Adult Biomarkers Biomarkers CA-125 Antigen Endometriosis Female Humans Membrane Proteins Predictive Value of Tests Sensitivity and Specificity

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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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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