G. Ozaksit et al., SERUM CA-125 LEVELS BEFORE, DURING AND AFTER TREATMENT FOR ENDOMETRIOSIS, International journal of gynaecology and obstetrics, 50(3), 1995, pp. 269-273
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.