Diagnostic use of CA 125 values measured on the 2nd and 14th days of the menstrual cycle in endometriosis

Year 2022, Volume: 6 Issue: 5, 586 - 590, 01.05.2022

Hüseyin Aytuğ Avşar , Sefa Kurt , Murat Celiloğlu Tunç Timur

https://doi.org/10.28982/josam.988164

Abstract

Background/Aim: This study examines the difference of serum CRP and CA 125 levels between the menstrual and non-menstrual phases of the menstrual cycle (days 2 and 14) and aims to investigate the diagnostic value of these markers for the early diagnosis of endometriosis.
Methods: There were 36 patients in the study group and 30 patients in the control group (n = 66) in this prospective case-control study. The patients in the study group, who were prediagnosed with endometriosis, were tested for serum CA 125 and CRP on the 2nd and 14th days of menstrual cycle preoperatively (during menstruation and non-menstrual phase) and underwent surgery. The women in the control group were patients who visited the outpatient clinic for a regular checkup without any gynecological complaints.
Results: The CA 125 levels were significantly higher on the 2nd day of the menstrual cycle than the 14th day in the study group [108.15 (90.33) U/mL and 58.60 (39.53) U/mL, respectively, P < 0.001]. In the control group, the CA 125 levels were also significantly higher on the 2nd day than the 14th day [22.97 (15.42) U/mL and 13.82 (6.82) U/mL, respectively, P < 0.001]. When the comparison was made between the CRP levels on the 2nd and 14th day for the study group [4.52 (4.45) mg/L and 2.82 (3.79) mg/L, respectively], the levels were significantly higher on the 2nd day (P < 0.001). The difference of CA 125 and CRP levels between the days [for the study group: ΔCA 125 = 49.55 (56.89) U/mL, ΔCRP = 1.69 (3.45) mg/L and for the control group ΔCA 125 = 9.14 (11.95) U/mL, ΔCRP = 1.42 (4.74) mg/L] were higher for both markers in the study group, and the differences with the control group were statistically significant (P < 0.001 for ΔCA 125 and P = 0.033 for ΔCRP).
Conclusion: Our data indicates that it may be possible to support the diagnosis with the evaluation of CA 125 levels during different phases of menstruation separately.

Keywords

Endometriosis, CA 125, CRP, Menstrual cycle

References

• 1. Houston DE, Noller KL, Melton LJ, Selwyn BJ, Hardy RJ. Incidence of pelvic endometriosis in Rochester, Minnesota, 1970-1979. Am J Epidemiol [Internet]. 1987;125(6):959–69. doi: 10.1093/OXFORDJOURNALS.AJE.A114634
• 2. Calhaz-Jorge C, Mol BW, Nunes J, Costa AP. Clinical predictive factors for endometriosis in a Portuguese infertile population. Hum Reprod [Internet]. 2004;19(9):2126–31. doi: 10.1093/HUMREP/DEH374
• 3. Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril [Internet]. 1997;68(4):585–96. doi: 10.1016/S0015-0282(97)00191-X
• 4. Zeng F, Xue M. [Diagnostic value of the detection of aromatase cytochrome P450 and CA 125 for endometriosis]. Zhong nan da xue xue bao Yi xue ban. J Cent South Univ Med Sci. 2005 Dec;30(6):682–5.
• 5. Agic A, Xu H, Finas D, Banz C, Diedrich K, Hornung D. Is endometriosis associated with systemic subclinical inflammation? Gynecol Obstet Invest [Internet]. 2006 Sep;62(3):139–47. doi: 10.1159/000093121
• 6. Šmuc T, Pucelj MR, Šinkovec J, Husen B, Thole H, Rižner TL. Expression analysis of the genes involved in estradiol and progesterone action in human ovarian endometriosis. Gynecol Endocrinol [Internet]. 2007 Feb;23(2):105–11. doi: 10.1080/09513590601152219
• 7. Hirsch M, Duffy JMN, Davis CJ, Nieves Plana M, Khan KS. Diagnostic accuracy of cancer antigen 125 for endometriosis: a systematic review and meta-analysis. BJOG [Internet]. 2016 Oct 1;123(11):1761–8. doi: 10.1111/1471-0528.14055
• 8. Oliveira MAP, Raymundo TS, Soares LC, Pereira TRD, Demôro AVE. How to Use CA-125 More Effectively in the Diagnosis of Deep Endometriosis. Biomed Res Int [Internet]. 2017;2017. doi: 10.1155/2017/9857196
• 9. Santos TMV, Pereira AMG, Lopes RGC, Depes DDB. Lag time between onset of symptoms and diagnosis of endometriosis. Einstein (Sao Paulo) [Internet]. 2012 Jan;10(1):39–43. doi: 10.1590/S1679-45082012000100009
• 10. May KE, Conduit-Hulbert SA, Villar J, Kirtley S, Kennedy SH, Becker CM. Peripheral biomarkers of endometriosis: a systematic review. Hum Reprod Update [Internet]. 2010 May 12;16(6):651–74. doi: 10.1093/HUMUPD/DMQ009
• 11. Xavier P, Belo L, Beires J, Rebelo I, Martinez-de-Oliveira J, Lunet N, et al. Serum levels of VEGF and TNF-alpha and their association with C-reactive protein in patients with endometriosis. Arch Gynecol Obstet [Internet]. 2006 Jan;273(4):227–31. doi: 10.1007/S00404-005-0080-4
• 12. Chamié LP, Blasbalg R, Ricar-do Mendes AP, Warmbrand G, Serafini PC. Findings of pelvic endometriosis at transvaginal US, MR imaging, and laparoscopy. Radiographics [Internet]. 2011 Jul;31(4). doi: 10.1148/RG.314105193
• 13. Abrao MS, Gonçalves MODC, Dias JA, Podgaec S, Chamie LP, Blasbalg R. Comparison between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis. Hum Reprod [Internet]. 2007;22(12):3092–7. doi: 10.1093/HUMREP/DEM187
• 14. Kafali H, Artuc H, Demir N. Use of CA 125 fluctuation during the menstrual cycle as a tool in the clinical diagnosis of endometriosis; a preliminary report. Eur J Obstet Gynecol Reprod Biol [Internet]. 2004 Sep 10;116(1):85–8. doi: 10.1016/J.EJOGRB.2004.02.039
• 15. Fassbender A, Burney RO, O DF, D’Hooghe T, Giudice L. Update on Biomarkers for the Detection of Endometriosis. Biomed Res Int [Internet]. 2015;2015. doi: 10.1155/2015/130854
• 16. Somigliana E, Viganò P, Tirelli AS, Felicetta I, Torresani E, Vignali M, et al. Use of the concomitant serum dosage of CA 125, CA 19-9 and interleukin-6 to detect the presence of endometriosis. Results from a series of reproductive age women undergoing laparoscopic surgery for benign gynaecological conditions. Hum Reprod [Internet]. 2004;19(8):1871–6. doi: 10.1093/HUMREP/DEH312
• 17. Koninckx PR, Meuleman C, Oosterlynck D, Cornillie FJ. Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration. Fertil Steril. 1996 Feb;65(2):280–7.
• 18. Mol BWJ, Bayram N, Lijmer JG, Wiegerinck MAHM, Bongers MY, Van Der Veen F, et al. The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis. Fertil Steril [Internet]. 1998 Dec;70(6):1101–8. doi: 10.1016/S0015-0282(98)00355-0.