THE USE OF SERUM CA-125 AS A MARKER FOR ENDOMETRIOSIS IN PATIENTS WITH DYSMENORRHEA FOR MONITORING THERAPY AND FOR RECURRENCE OF ENDOMETRIOSIS

Background. To estimate the value of CA-125 for the diagnosis of endom etriosis in women with dysmenorrhea, as well as its significance in mo nitoring therapy and follow-up. Methods. One hundred and fifty-seven w omen undergoing laparoscopy for dysmenorrhea were prospectively studie d for serum CA-125 concentration. For those with advanced endometriosi s receiving danazol treatment after conservative surgery, CA-125 was a lso determined every month during medication and once every 12 months after treatment. Results. The sensitivity and specificity of serum CA- 125 for the diagnosis of endometriosis were 61.1% and 87.5% respective ly. Elevated CA-125 (>35 U/ml) was noted in 65/75 cases (86.7%) with a dvanced endometriosis, but in only 15/56 patients (26.8%) with minimal and mild endometriosis. Although there were significantly higher CA-1 25 levels in unmarried women, and a negative correlation (r=-0.1970, p =0.0284) between CA-125 and parity, there was no statistical differenc e in incidence of endometriosis by the status of marriage or parity. T en women with advanced endometriosis were found with persistent endome triosis by laparoscopy during danazol treatment, even though they test ed with normal CA-125 levels (<35 U/ml) at that time. Fifteen patients had elevated CA-125 levels before and one year after therapy, and wer e confirmed with recurrence of endometriosis by laparoscopy. Nine wome n with elevated CA-125 levels before treatment, were found without rec urrence of endometriosis and had normal CA-125 levels one year after t herapy. Conclusion. For endometriosis, CA-125 is a valuable adjuvant i n the follow-up of recurrence in patients with advanced endometriosis and initially elevated CA-125 levels. It is not an effective screening tool for patients with dysmenorrhea, or for monitoring therapy. There was no significant correlation between the development of endometrios is and reproductive factors.