Diagnostic accuracy of cancer antigen 125 for endometriosis: a systematic review and meta‐analysis

Hirsch, Martin S.; Duffy, J.M.; Davis, CJ; Plana, Maria; Khan, Khalid S.

doi:10.1111/1471-0528.14055

Cited by 110 publications

(82 citation statements)

References 65 publications

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“…CA 125 is particularly useful in diagnosing and detecting the recurrence of gynecologic tumors (18,19); this marker is also observed in patients with lung, breast and gastrointestinal tract cancer. Evaluated CA 19-9 is often found in patients with gastrointestinal tumors.…”

Section: Discussionmentioning

confidence: 99%

“…The results of one published meta-analysis, including 21 studies with a total of 2,861 cases, were similar to our study and showed that the sensitivity and specificity of CA 15-3 in the diagnosis of MPE were 0.58 (95% CI: 0.56-0.61) and 0.91 (95% CI, 0.90-0.93) (17). However, we suggest that CA 15-3 alone is not recommended due to its limited sensitivity.CA 125 is particularly useful in diagnosing and detecting the recurrence of gynecologic tumors (18,19); this marker is also observed in patients with lung, breast and gastrointestinal tract cancer. Evaluated CA 19-9 is often found in patients with gastrointestinal tumors.…”

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confidence: 99%

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Diagnostic accuracy of tumor markers for malignant pleural effusion: a derivation and validation study

Zhai¹,

Wang²,

Wang³

et al. 2017

J. Thorac. Dis.

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Background: The utility of tumor markers (TMs) for differentiating malignant pleural effusion (MPE) from benign pleural effusion (BPE) has been a subject of controversy. The majority of published studies are single center designed and lack validation. We performed a derivation and validation study in China to evaluate the diagnostic value of carcinoembryonic antigen (CEA) as well as carbohydrate antigen (CA) 15-3, CA 19-9 and CA 125 to differentiate between MPE and BPE. Methods: Three hundred and twenty seven pleural effusion (PE) and paired serum samples were collected from consecutive patients with MPE or BPE in Beijing (174 patients, derivation) and Wuhan (153 patients, validation) during the same period. The concentrations of four TMs were tested using chemiluminescent microparticle immunoassay technology. The performance of the TMs was analyzed by standard receiver operating characteristic (ROC) curves. Results: The levels of four TMs were significantly higher in MPE than in BPE and the corresponding serum. The concentrations of CEA and CA 15-3 were more stable than the concentrations of CA 125 and CA 19-9. CEA was the best single marker for discriminating MPE from BPE. With a specificity of 100% in the total population, the highest sensitivity (37.8%) using serum was found in CEA. In addition, CEA presented 19.8% sensitivity in PE and 18.0% sensitivity in the ∆(PE-serum). For CA 15-3, the sensitivity was 32.4% in PE, 15.3% in the PE/serum ratio and 25.2% in the ∆(PE-serum).Conclusions: CEA and CA 15-3 rather than CA 125 and CA 19-9 are more reliable to differentiate between MPE and BPE. The use of the ∆(PE-serum) value in TMs, such as CEA and CA 15-3, may improve the sensitivity and specificity of the diagnosis etiology of PE.Keywords: Pleural effusion (PE); tumor marker (TM); diagnosis; carcinoembryonic antigen (CEA); CA 125; CA Submitted Jan 13, 2017. Accepted for publication Aug 15, 2017Aug 15, . doi: 10.21037/jtd.2017 View this article at: http://dx.doi.org/10.21037/jtd.2017.11.62 5221 Journal of Thoracic Disease, Vol 9, No 12 December 2017 © Journal of Thoracic Disease. All rights reserved.J Thorac Dis 2017;9(12):5220-5229 jtd.amegroups.com IntroductionMalignant pleural effusion (MPE) is frequently observed in some malignancies, implying systemic spread of cancer and reduction of life expectancy and quality (1). The initial diagnostic approaches to differentiation between benign pleural effusions (BPEs) and MPEs include thoracocentesis and cytological, histological and biochemical examinations; however, the sensitivity of these non-invasive techniques is only 40-70% (2). Many studies have investigated the usefulness of a number of tumor markers (TMs), including carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125, CA 15-3, and CA 19-9, in pleural fluid for the diagnosis of MPE (3). Our previous meta-analyses indicated that current evidence does not recommend using a single TM for the diagnosis of MPE; a combination of two or more TMs seemingly is more sensitive (4,5). We, along with oth...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Diagnostic accuracy of tumor markers for malignant pleural effusion: a derivation and validation study

Zhai¹,

Wang²,

Wang³

et al. 2017

J. Thorac. Dis.

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“…Serum cancer antigen 125 (CA‐125), also known as mucin 16 (MUC16) is a protein that belongs to the mucin family of glycoproteins and is expressed by epithelia as a response to infectious agents and foreign particles . As a biomarker it is mainly used to diagnose endometriosis and ovarian cancer as well as during the follow‐up period of patients treated for ovarian cancer . Despite its relatively high specificity, its sensitivity remains low and, thus, a negative test is unable to rule out the presence of these diseases.…”

Section: Introductionmentioning

confidence: 99%

“…7 As a biomarker it is mainly used to diagnose endometriosis and ovarian cancer as well as during the follow-up period of patients treated for ovarian cancer. 8,9 Despite its relatively high specificity, its sensitivity remains low and, thus, a negative test is unable to rule out the presence of these diseases. A recent metaanalysis in the field of heart failure implied that serum CA-125 may be used as a biomarker that could help diagnose, stratify and predict Abstract Background: Preeclampsia is a leading cause of perinatal morbidity, although an optimal screening model is still under investigation.…”

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Serum CA‐125 levels in preeclampsia: A systematic review and meta‐analysis

et al. 2019

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Background Preeclampsia is a leading cause of perinatal morbidity, although an optimal screening model is still under investigation. The aim of the present meta‐analysis is to accumulate current evidence and evaluate the diagnostic accuracy of CA‐125 in preeclampsia. Materials and Methods Medline, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar were systematically searched. All studies reporting serum CA‐125 among preeclamptic and healthy pregnant women were selected. Results Nine studies involving 977 women were included. Meta‐analysis revealed significant differences among patients with preeclampsia and control pregnant women (MD 15.86 IU/mL, 95% CI, 9.03‐22.69). Patients with severe preeclampsia had significantly higher levels of CA‐125 compared to patients with mild preeclampsia (MD 13.21 IU/mL, 95% CI, 1.94‐24.49). Meta‐regression analysis revealed that gestational age <34 weeks could positively affect this association. Conclusions The present meta‐analysis suggests that serum CA‐125 levels are increased in preeclamptic women during the third trimester of pregnancy. This association should be interpreted with caution as there are concerns for significant selection bias. Future studies are needed to corroborate these findings and investigate the diagnostic accuracy of this biomarker during early pregnancy.

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“…Research has been carried out investigating biomarkers in diagnosing endometriosis, in particular CA 125. While there is some diagnostic use as a ‘rule in’ test, its sensitivity remains poor and performs poorly as a ‘rule out’ test with almost half of patients with endometriosis having a negative test 7. A validated assessment tool exists based purely off examination and ultrasound findings, however, this only lends itself to ovarian endometriosis 8.…”

Section: Discussionmentioning

confidence: 99%

Endometriosis presenting as a vaginal mass

Nelson

2018

BMJ Case Reports

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A 43-year-old woman with an anterior vaginal wall mass was referred to gynaecology outpatient for diagnosis and management. Clinical assessment was indicative of a urethral diverticulum, however MRI and ultrasound imaging suggested a Gartner’s duct cyst. Following excision of the lesion, histology revealed evidence of an endometriotic cyst. The patient had no other symptoms of endometriosis and remained asymptomatic 3 months following excision. This case highlights the widespread locations in which endometrial tissue can be found, and therefore the range of symptomatology. This in turn lends itself to diagnostic difficulty without histological confirmation.

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Diagnostic accuracy of cancer antigen 125 for endometriosis: a systematic review and meta‐analysis

Abstract: Blood test CA 125: a rule-in test for the diagnosis of women presenting with symptoms of endometriosis.

Cited by 110 publications

References 65 publications

Diagnostic accuracy of tumor markers for malignant pleural effusion: a derivation and validation study

Diagnostic accuracy of tumor markers for malignant pleural effusion: a derivation and validation study

Serum CA‐125 levels in preeclampsia: A systematic review and meta‐analysis

Endometriosis presenting as a vaginal mass

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