Pr. Koninckx et al., CA-125 IN THE MANAGEMENT OF ENDOMETRIOSIS, European journal of obstetrics, gynecology, and reproductive biology, 49(1-2), 1993, pp. 109-113
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.