PELVIC INFLAMMATORY DISEASE - CORRELATION OF SEVERITY WITH CA-125 LEVELS

OBJECTIVE: To determine whether elevated levels of cancer antigen 125 (CA-125) correlate with the severity and clinical outcome of pelvic in flammatory disease. STUDY DESIGN: CA-125 levels were measured prospect ively in 36 women with pelvic inflammatory disease using a commercial immunoassay. Initial inclusion criteria were abdominal tenderness, cer vical motion tenderness and adnexal tenderness. Patients then were cat egorized into three groups based on the severity of the illness. Group 1 included patients with (1) temperature greater than or equal to 38. 0 but < 38.5 degrees C or (2) WBC count greater than or equal to 10 bu t < 15 x 10(3) cells/mu L. Group 2 included patients with (1) temperat ure greater than or equal to 38.5 degrees C or (2) WBC count greater t han or equal to 15 x 10(3) cells/mu L. Group 3 included patients who f ulfilled the same criteria as group 2 but who also had an adnexal mass . Differences in CA-125 levels were compared statistically using the u npaired Student t test. RESULTS: All patients with the diagnosis of pe lvic inflammatory disease had CA-125 levels > 30 U/mL, with a range of 48-656. Moreover, the levels were significantly different among the t hree groups (group 1 vs. 2, P = .002; 1 vs. 3, P = .001, 2 vs. 3, P = .001), and a correlation between severity of disease and CA-125 levels was found. All patients with a presumed pelvic abscess had CA-125 lev els in the range for neoplastic processes. CONCLUSION: Elevated CA-125 levels correlate with the severity of pelvic inflammatory disease and outcome. Pelvic inflammatory disease must be considered in the differ ential diagnosis of elevated CA-125 levels and pelvic masses.