Diagnostic accuracy of Cancer Antigen 125 (CA125) for endometriosis in symptomatic women: A multi-center study

Hirsch, Martin S.; Duffy, James M N; Deguara, Christine S.; Davis, Colin J.; Khan, Khalid S.

doi:10.1016/j.ejogrb.2016.12.002

Cited by 56 publications

(44 citation statements)

References 21 publications

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“…The expression of BCL6 (Evans-Hoeker et al, 2016 ) has been reported to be altered in secretory phase endometrial biopsies and may be useful diagnostically, but this approach will require invasive biopsy procedures. Other possible diagnostic markers for endometriosis include CA-125 (Hirsch et al, 2017 ), VEGF, microRNAs, immunologic markers, and soluble ICAM levels (Acimovic et al, 2016 ; Vodolazkaia et al, 2016 ; Gagné et al, 2003 ; Matalliotakis et al, 2001 ; Kuessel et al, 2017 ; Mosbah et al, 2016 ; Bohler et al, 2007 ; Drosdzol-Cop et al, 2012 ; Wu et al, 2015 ); however, none of these can identify endometriosis patients with both high sensitivity and specificity. It is clear that the need for a non-invasive diagnostic marker or method remains, and it would appear that the analysis of ME may offer a path to develop such tests.…”

Section: Discussionmentioning

confidence: 99%

Analysis of menstrual effluent: diagnostic potential for endometriosis

Warren

Shih

Renteira

et al. 2018

Mol Med

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BackgroundEndometriosis is a chronic and underdiagnosed disease which affects 5–10% of women of childbearing age and is characterized by growth of endometrial tissue outside of the uterus, most often in the peritoneal cavity. Delay in diagnosis is a major problem for management of this disorder, and treatment is often not initiated until the disease has progressed for many years. Although the exact etiology of endometriosis remains unknown, retrograde menstruation is recognized as a common underlying factor leading to the deposit of menstrual effluent (ME) into the peritoneal cavity. Differences in the cellular biology and genetics of the cells within ME are therefore likely to explain why endometriosis develops in only a subset of women.MethodsPatients with and without endometriosis were consented to provide ME. ME was analyzed by flow cytometry for CD45- and CD45+ cell populations or used to isolate stromal fibroblast cells. ME-derived stromal fibroblast cells were assessed using decidualization assays following the addition of cAMP and IGFBP-1 concentrations in the culture supernatants were measured by ELISA. In addition, RNA was collected and analyzed by RNA-Seq and qPCR for markers of decidualization and to identify differentially expressed genes in ME-derived stromal fibroblast cells obtained from controls and subjects with endometriosis (±cAMP).ResultsFlow cytometry analysis of cell subsets within the CD45+ fraction of ME revealed a significant decrease in the number of uterine NK cells in endometriosis patients compared with controls (p < 0.01). No other significant differences within either the CD45+ or CD45- cell populations were observed. Most strikingly, ME-derived stromal fibroblast cells cultured from endometriosis subjects showed impaired decidualization potential compared with controls. Highly significant differences in decidualization response were detected by measuring IGFBP-1 production at multiple time points after cAMP stimulation (p = 0.0025 at 6 h; p = 0.0045 at 24 h; p = 0.0125 at 48 h). RNA-Seq and qPCR analyses were used to identify genes differentially expressed by ME-derived stromal fibroblast cells obtained from endometriosis and control subjects.ConclusionsMenstrual effluent can be useful for investigating the pathobiology of endometriosis and for developing a non-invasive diagnostic for endometriosis which may lead to earlier and more effective treatments for this common disorder.Electronic supplementary materialThe online version of this article (10.1186/s10020-018-0009-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Analysis of menstrual effluent: diagnostic potential for endometriosis

Warren

Shih

Renteira

et al. 2018

Mol Med

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“…Although we included women who underwent IVF treatment with or without ICSI, five studies excluded patients with endometriosis [12][13][14][15]17]. It is likely that Ca-125 concentrations are known to be elevated in endometriosis [18]; therefore, evidence related to the correlation between serum Ca-125 level in endometriosis and pregnant outcome is still lacking, which may reduce the overall applicability of the evidence.…”

Section: Discussionmentioning

confidence: 99%

“…Considering that Ca-125 concentrations are known to be elevated in endometriosis [18], We excluded studies that might include patients with endometriosis [11,16] before ET. The result showed that there was no significant difference in the serum Ca-125 level between clinical pregnant group and nonpregnant group (SMD 0.31; 95% CI [-0.53, 1.16], P = 0.47, I 2 = 89%; Fig.…”

Section: The Correlation Between Serum Ca-125 Level Before Et and CLImentioning

confidence: 99%

The correlation between serum Ca-125 level and clinical pregnancy in in vitro fertilization (IVF): A meta-analysis

Wang

Zhang

et al. 2019

Preprint

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Background Several studies had investigated the role of serum Ca-125 in clinical pregnancy of patients undergoing in vitro fertilization (IVF); however, their conclusions had been inconsistent. This study aimed to evaluate the correlation between serum Ca-125 level and clinical pregnancy in IVF. MethodsWe systematically review the studies in the databases of Mediline OvidSP, EMBASE OvidSP and Cochrane (CENTRAL Central Register of Controlled Trials). Studies on the correlation between serum Ca-125 level and clinical pregnancy in patients underging IVF with or without Intracytoplasmic sperm injection (ICSI) were considered. The pooled standardized mean difference (SMD) with 95% confidence intervals (CIs) was used in the analysis.Results Seven studies involving 558 patients were included. The meta-analysis showed that there was no significant difference in the serum Ca-125 level before embryo transfer (ET) between clinical pregnant group and nonpregnant group (SMD 0.72; 95% CI [0.01, 1.43], P = 0.05, I 2 = 88%), and the same conclusion was also reached in patients without endometriosis (SMD 0.31; 95% CI [-0.53, 1.16], P = 0.47, I 2 = 89%); However, after embryo transfer, the result showed that the Ca-125 level has a small but significantly increase in the clinical pregnant group than in the nonpregnant group (SMD 0.39; 95% CI [0.09, 0.69], P = 0.01, I 2 = 0%).Conclusions Berore ET, there was no significant correlation between serum Ca-125 level and clinical pregnancy in IVF; After ET, the Ca-125 level has a small but significantly increase in the clinical pregnant group than in the nonpregnant group, and it might reflect a successful interaction between the embryo and the endometrium in that time period.

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“…Despite this, there is as yet no available biomarker or panel of biomarkers for endometriosis that meet the following criteria of the 2010 Biomarkers Definition Working Group of the National Institutes of Health: "a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacological responses to a therapeutic intervention" [10]. The tumor marker cancer antigen-125 (CA-125) is used most frequently in endometriosis, although it has been associated with limited diagnostic performance [11,12].…”

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confidence: 99%

The additional diagnostic value of NLR and PLR for CA-125 in the differential diagnosis of endometrioma and benign ovarian cysts in women of reproductive age: a retrospective case-control study

Kalem¹,

Bakırarar

Kalem

2020

The European Research Journal

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Objectives: Aim of this study is to investigate the diagnostic value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) for cancer antigen-125 (CA-125) in a differential diagnosis of endometrioma from benign ovarian cysts. Methods: In this retrospective study, the medical data of a total of 213 patients aged < 40 years who underwent laparoscopic or laparotomic surgery for ovarian cysts between April 2015 and June 2018 were analyzed. The patients were divided into two groups, as those with endometriomas and those with other benign ovarian cysts, all which had been confirmed histopathologically. Data on age, body mass index (BMI), preoperative US findings, complete blood count analysis results, follicle-stimulating hormone (FSH) levels, and the presence of dysmenorrhea, dyspareunia and chronic pelvic pain were recorded. Results: NLR, PLR and CA-125 were increased in the patients with endometrioma, although increases in the NLR and PLR alone or combined did not contribute to the sensitivity or specificity of CA-125. Conclusions: The results of our study suggest that NLR and PLR did not contribute to the diagnostic value of CA-125 in the preoperative differential diagnosis of endometriomas or other benign ovarian cysts. In addition, CA-125 was not associated with clinical symptoms, although a relationship was identified between NLR and dysmenorrhea, and between PLR and lesion size, which may be the research focus of further studies.

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Diagnostic accuracy of Cancer Antigen 125 (CA125) for endometriosis in symptomatic women: A multi-center study

Abstract: CA 125≥30u/ml is highly predictive of endometriosis in women with symptoms of pain and/or subfertility. CA 125 should be considered as a rule-in test for expediting the diagnosis and management of endometriosis, CA 125 <30u/ml is, however, unable to rule out endometriosis.

Cited by 56 publications

References 21 publications

Analysis of menstrual effluent: diagnostic potential for endometriosis

Analysis of menstrual effluent: diagnostic potential for endometriosis

The correlation between serum Ca-125 level and clinical pregnancy in in vitro fertilization (IVF): A meta-analysis

The additional diagnostic value of NLR and PLR for CA-125 in the differential diagnosis of endometrioma and benign ovarian cysts in women of reproductive age: a retrospective case-control study

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