SERUM CA-125 LEVELS BEFORE, DURING AND AFTER TREATMENT FOR ENDOMETRIOSIS

Objectives: The aim of this study was to assess the treatment of endom etriosis with a gonadotropin-releasing hormone (GnRH) agonist in terms of changes to the extent of disease and to CA 125 levels as well as t o recurrence during follow-up. Methods: The levels of serum CA 125 wer e evaluated in 66 patients with endometriosis diagnosed and staged by laparoscopy according to the revised American Fertility Society classi fication, who received a 6-month course of a GnRH agonist. Serum CA 12 5 levels were measured before, during (3 and 6 months after the initia tion of therapy) and 6 months after cessation of therapy. Results. Pat ients with minimal and mild endometriosis had significantly higher mea n pretreatment values than control subjects in the luteal phase of the cycle or than postmenopausal women (P < 0.05), but the overall mean v alue was still below 35 U/ml. Levels of CA 125 fell during treatment t o those found in normal controls, but rose again after the end of trea tment. The sensitivity and specificity of CA 125 were 75% and 83.3%, r espectively, and its positive predictive value as a marker of recurren ce was 46.36%. Conclusion. These data suggest that CA 125 may be a rel iable indicator for monitoring the efficacy of GnRH agonist treatment of endometriosis, but its value as a predictor of recurrence is low, p robably due to the suppression of all CA 125 sources such as endometri um, ovaries and implants.