Serum and peritoneal CA-125 levels as diagnostic test for endometriosis.

OBJECTIVE

To evaluate the clinical utility of CA-125 in the diagnosis of endometriosis and to compare the sensitivity of the serum and the peritoneal test as indicator of disease.

STUDY

DESIGN

Peritoneal fluid was obtained at laparoscopy. The quantitative determination of CA-125 in serum and in peritoneal fluid was performed by IRMA-mat CA-125 'two-step method', a two-site immunoradiometric assay, using 35 and 60 U/ml as cutoff.

SETTING

Second Department of Gynecology and Obstetrics, Second University of Naples, Italy.

PARTICIPANTS

A total of 26 women infertile undergoing diagnostic laparoscopy that exhibited endometriosis in 14 patients, normal pelvis in 12 patients (control group).

INTERVENTIONS: None.

RESULTS

CA-125 levels in peritoneal fluid were higher than those found in serum and were significantly elevated (P < 0.05), when compared with the control group, both in women with endometriosis stage I-II and stage III-IV. In serum, CA-125 levels increased only in advanced stage of endometriosis.

CONCLUSIONS

Levels of CA-125 in peritoneal fluid seem to be a more sensitive indicator of disease than serum levels (0.86 vs. 0.36), especially in early stage endometriosis (0.80 vs. 0.20) which tends to be overlooked by the CA-125 serum test.