Serum CA-125 in preoperative patients at high risk for endometriosis

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)375-380
Number of pages6
JournalObstetrics and Gynecology
Volume99
Issue number3
DOIs
Publication statusPublished - 2002 Mar 12

Fingerprint

Endometriosis
Serum
Omentum
ROC Curve
Sample Size
Reproductive Medicine
Fallopian Tubes
Peritoneum
Ovary
Colon
Students

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology

Cite this

@article{402d3342cbb04cd1871171a801b6ed8e,
title = "Serum CA-125 in preoperative patients at high risk for endometriosis",
abstract = "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.",
author = "Ya-Min Cheng and Shan-Tair Wang and Cheng-Yang Chou",
year = "2002",
month = "3",
day = "12",
doi = "10.1016/S0029-7844(01)01731-8",
language = "English",
volume = "99",
pages = "375--380",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

Serum CA-125 in preoperative patients at high risk for endometriosis. / Cheng, Ya-Min; Wang, Shan-Tair; Chou, Cheng-Yang.

In: Obstetrics and Gynecology, Vol. 99, No. 3, 12.03.2002, p. 375-380.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Serum CA-125 in preoperative patients at high risk for endometriosis

AU - Cheng, Ya-Min

AU - Wang, Shan-Tair

AU - Chou, Cheng-Yang

PY - 2002/3/12

Y1 - 2002/3/12

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0036188678&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036188678&partnerID=8YFLogxK

U2 - 10.1016/S0029-7844(01)01731-8

DO - 10.1016/S0029-7844(01)01731-8

M3 - Article

C2 - 11864662

AN - SCOPUS:0036188678

VL - 99

SP - 375

EP - 380

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 3

ER -