Clinical significance of serum CA125 for endometriosis diagnosis

Objective To evaluate the relationship between serum CA125 levels and r-AFS stage of endometriosis, and to evaluate the serum CA125 level associated with rupture of ovarian endometrioma.Methods Ninety-three patients diagnosed by laparoscopy or laparotomy with endometriosis were included in the study. Four groups were divided according to the different stage of endometriosis: group I: stage I, 16 cases; group Ⅱ: stage Ⅱ, 20 cases; group Ⅲ: stage Ⅲ, 25 cases; group Ⅳ: stage Ⅳ, 32 cases. Group A: rupture of ovarian endometrioma, 14 cases; group B: unrupture of ovarian endometrioma, 70 cases. Serum CA125 levels were measured by chemiluminescence analysis before operation.Results (1) Serum CA125 levels in stage Ⅲ and stage Ⅳ were higher than those in stage I and stage Ⅱ (P0.05). (2) If the diagnostic standard of endometriosis by CA125 was above 35U/ml, the sensitivity was 37.5% for stage Ⅰ, 50% for satge Ⅱ, 72%for stage Ⅲand 81.25% for stage Ⅳ. (3)If the diagnosis standard of endometriosis by CA125 was above 70U/ml, the sensitivity of diagnotic in rupture of ovarian endometrioma was 64.22%. The specificity was 88.57%, the positive predictive value was 52.94%. The negative predictive value was 92.54%. There was a statistically significant difference between the ovarian rupture group and the unrupture group (P0.05).Conclusion Serum CA125 testing for diagnosis of endometriosis stage may have a considerable value, It is a sensitive marker particularly for stageⅢand Ⅳ of endometriosis. Serum CA125 above 70U/ml is Specific preoperative diagnosis of ovarian endometrioma rupture, but serum CA125 is insensitive for diagnosis of mild endometriosis.