CA-125 IN THE MANAGEMENT OF ENDOMETRIOSIS

CA 125 is expressed by ectopic and ectopic endometrium. In women with advanced endometriosis, plasma concentrations are increased towards th e end of the luteal phase and during menstruation but not during the f ollicular and early luteal phases. In women without endometriosis, suc h cyclic changes of CA 125 in plasma are not observed. In women with c ystic ovarian endometriosis, plasma CA 125 concentrations are markedly elevated. Measurement of CA 125 in ovarian cyst fluid is the method o f choice to differentiate a cystic corpus luteum from an ovarian endom etriotic cyst, a frequent and difficult clinical problem. CA 125 can b e used to diagnose deeply infiltrating endometriosis with a sensitivit y of 36% and a specificity of 87%. These figures underestimate the cli nical importance, since plasma CA 125 concentrations are mainly import ant for the diagnosis of deeply infiltrating endometriosis types II an d III, which are the most severe forms and which are clinically easily missed. Because of the strong association of deep endometriosis and p elvic pain, the assay of CA 125 in plasma may be advocated in all wome n with unexplained pelvic pain as an aid in the diagnosis of deeply in filtrating endometriosis. Following surgical excision of endometriosis , CA 125 can be used to monitor the completeness of surgery.