OBJECTIVE: To investigate the factors contributing to the elevated level of CA-125 in endometriosis and to study whether CA-125 assay is useful to identify women who require preoperative bowel preparation. METHODS: A total of 685 women undergoing surgery for endometriosis between July 1988 and June 1999 were studied. Preoperative serum CA-125 levels were compared between various pelvic conditions using F statistics. Multiple regression was employed to determine significant correlates of elevated serum CA-125, and the receiver operating characteristic curve was applied to assess the utility of serum CA-125 in preoperative preparation. Based on the two-sample Student t test, the sample size required to detect a difference in mean serum CA-125 levels of one-half of one standard deviation with a power of 90% when the sample size ratio of the two groups was 1:50 was 675 with a significance level of 5%. RESULTS: The mean serum CA-125 levels (IU/mL) for American Society of Reproductive Medicine stages I, II, III, and IV endometriosis were 18.8 +/- 0.9, 40.3 +/- 2.8, 77.1 +/- 3.5, and 182.4 +/- 14.0, respectively. CA-125 levels were significantly increased with advanced stages (P <.001, F test). Furthermore, serum CA-125 levels were significantly higher in patients with more extensive adhesions to the peritoneum, omentum, ovary, fallopian tube, colon, and cul-de-sac, or with ruptured endometrioma (P <.001, F test). We then classified patients with at least one of the three factors including dense omentum adhesion, ruptured endometrioma, and complete cul-de-sac obliteration as the high-risk group that required preoperative bowel preparation, and the others as the low-risk group. Receiver operating characteristic curve analyses set a cutoff point of 65 IU/mL, which gave a sensitivity of 76%, a specificity of 71%, a positive predictive value of 76%, and a negative predictive value of 93.2%. CONCLUSION: Our results suggest that preoperative CA-125 assay is useful to decide which women should receive preoperative bowel preparation. Endometriosis patients with preoperative CA-125 levels higher than 65 IU/mL are at high risk for severe pelvic adhesions that warrant thorough preoperative bowel preparation.
OBJECTIVE: To investigate the factors contributing to the elevated level of CA-125 in endometriosis and to study whether CA-125 assay is useful to identify women who require preoperative bowel preparation. METHODS: A total of 685 women undergoing surgery for endometriosis between July 1988 and June 1999 were studied. Preoperative serum CA-125 levels were compared between various pelvic conditions using F statistics. Multiple regression was employed to determine significant correlates of elevated serum CA-125, and the receiver operating characteristic curve was applied to assess the utility of serum CA-125 in preoperative preparation. Based on the two-sample Student t test, the sample size required to detect a difference in mean serum CA-125 levels of one-half of one standard deviation with a power of 90% when the sample size ratio of the two groups was 1:50 was 675 with a significance level of 5%. RESULTS: The mean serum CA-125 levels (IU/mL) for American Society of Reproductive Medicine stages I, II, III, and IV endometriosis were 18.8 +/- 0.9, 40.3 +/- 2.8, 77.1 +/- 3.5, and 182.4 +/- 14.0, respectively. CA-125 levels were significantly increased with advanced stages (P <.001, F test). Furthermore, serum CA-125 levels were significantly higher in patients with more extensive adhesions to the peritoneum, omentum, ovary, fallopian tube, colon, and cul-de-sac, or with ruptured endometrioma (P <.001, F test). We then classified patients with at least one of the three factors including dense omentum adhesion, ruptured endometrioma, and complete cul-de-sac obliteration as the high-risk group that required preoperative bowel preparation, and the others as the low-risk group. Receiver operating characteristic curve analyses set a cutoff point of 65 IU/mL, which gave a sensitivity of 76%, a specificity of 71%, a positive predictive value of 76%, and a negative predictive value of 93.2%. CONCLUSION: Our results suggest that preoperative CA-125 assay is useful to decide which women should receive preoperative bowel preparation. Endometriosispatients with preoperative CA-125 levels higher than 65 IU/mL are at high risk for severe pelvic adhesions that warrant thorough preoperative bowel preparation.
Authors: Babatunde O Akinwunmi; Ana Babic; Allison F Vitonis; Daniel W Cramer; Linda Titus; Shelley S Tworoger; Kathryn L Terry Journal: Cancer Epidemiol Biomarkers Prev Date: 2018-09-20 Impact factor: 4.254
Authors: Vicki Nisenblat; Patrick M M Bossuyt; Rabia Shaikh; Cindy Farquhar; Vanessa Jordan; Carola S Scheffers; Ben Willem J Mol; Neil Johnson; M Louise Hull Journal: Cochrane Database Syst Rev Date: 2016-05-01
Authors: Jason M Franasiak; Katherine A Burns; Ov Slayden; Lingwen Yuan; Marc A Fritz; Kenneth S Korach; Bruce A Lessey; Steven L Young Journal: Reprod Sci Date: 2014-07-16 Impact factor: 3.060
Authors: C Van Holsbeke; B Van Calster; S Guerriero; L Savelli; F Leone; D Fischerova; A Czekierdowski; R Fruscio; J Veldman; G Van de Putte; A C Testa; T Bourne; L Valentin; D Timmerman Journal: Facts Views Vis Obgyn Date: 2009