Highly elevated serum CA-125 levels in patients with non-malignant gynecological diseases

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AI-generated summary by claude@2026-06+body, 2026-06-07

This study analyzed clinical characteristics of patients with non-malignant gynecologic diseases and highly elevated CA-125 levels, finding endometriosis and acute abdominal symptoms were common.

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This retrospective study enrolled 41 patients with non-malignant gynecologic diseases who had serum CA-125 levels over 1,000 IU/ml and compared their clinical characteristics with 71 patients with epithelial ovarian cancer with CA-125 levels over 1,000 IU/ml. In the non-malignant group, 43.9% had endometriosis; median CA-125 levels were much lower than in the ovarian cancer group, while the non-malignant patients were younger and had fewer prior pelvic mass histories but more acute abdominal symptoms and/or abnormal vaginal bleeding. Changes in serum CA-125 over follow-up (up to 386 days) correlated with clinical progression in both groups. The authors’ main limitation is that the non-malignant cohort was identified retrospectively by extreme CA-125 elevation, which may not represent all patients with milder elevations. This paper is centrally about endometriosis — endometriosis comprised 43.9% of the non-malignant patients with highly elevated CA-125 and is used to characterize the overlap between endometriosis and markedly increased CA-125.

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Abstract

Purposes To identify patients with highly elevated serum CA-125 levels and analyze their clinical characteristics.

Methods

Patients with non-malignant gynecologic disease (NMGDs, n = 41), in whom serum CA-125 levels were over 1,000 IU/ml were retrospectively enrolled in the study. Seventy-one patients with epithelial ovarian cancer (EOC), in whom, serum CA-125 levels were over 1,000 IU/ml were included as the comparison group. Clinical parameters were compared between the two groups.

Results

In NMGDs group, 43.90% of the patients had endometriosis. The median of serum CA-125 level in NMGDs was much lower than that of EOC subjects (P < 0.001). Compared to EOC group, the patients in NMGDs group were much younger (P < 0.001) and had fewer histories of pelvic masses (P < 0.001) but had more clinical complaints such as acute abdominal symptoms (P < 0.001) and/or abnormal vaginal bleeding (P = 0.022). Clinical progresses of these two groups were correlated with changes of serum CA-125 levels by follow-up for up to 386 days.

Conclusions

High levels of serum CA-125 were found not only in the EOC, but also in some NMGDs, especially in the reproductive patients with complaints of acute abdomen symptoms or abnormal vaginal bleeding.

References

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Condition tags

endometriosis

MeSH descriptors

CA-125 Antigen Genital Diseases, Female Membrane Proteins Abdomen, Acute Abdomen, Acute Adult Age Factors CA-125 Antigen Case-Control Studies Endometriosis Endometriosis Female Genital Diseases, Female Humans Leiomyoma Leiomyoma Membrane Proteins Middle Aged Retrospective Studies Uterine Hemorrhage

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