Serum carcinogenic antigen (CA)-125 and CA 19-9 combining pain score in the diagnosis of pelvic endometriosis in infertile women

Haibin Zhu, H Zhu, Lei Han, H Lei, Q Wang, J Fu, Jie Fu, Y Song, Yong‐Seok Song, Li Shen, L Shen, Wei Huang, W Huang
Clinical and experimental obstetrics & gynecology · 2016 · vol. 43(6) , pp. 826–829 · doi:10.12891/ceog3140.2016 · PMID:29944231 · W3024941938
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

Preoperative serum CA-125 and CA 19-9 levels, particularly when combined with pain scores, showed utility in predicting pelvic endometriosis in infertile women.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-06 · read from full text ⓘ

This study evaluated whether preoperative serum CA-125 and CA 19-9 levels, combined with a pain score, could predict pelvic endometriosis in 294 infertile women undergoing laparoscopy. Serum markers were measured during the follicular phase, then correlated with endometriosis occurrence and severity, and ROC analyses were used to define cut-off values and assess diagnostic performance. CA-125 and CA 19-9 differed significantly between women with and without endometriosis, and cut-offs of 18.25 IU/ml and 13.15 IU/ml yielded higher sensitivities for CA 19-9 but better specificity for CA-125; combining the two markers improved sensitivity and specificity relative to either alone, and adding the pain score produced overall sensitivity of 71.0% and specificity of 74.0%. This paper also contains a limitation that it was conducted in a single cohort of infertile women with laparoscopy, and the abstract does not describe external validation. This paper is centrally about endometriosis — it tests CA-125 and CA 19-9 combined with pain score for predicting pelvic endometriosis in infertile women.

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Abstract

OBJECTIVE: To define the utility of serum carcinogenic antigen (CA)-125 and CA 19-9 combining pain score in the prediction of pelvic endometriosis in infertile women. MATERIALS AND METHODS: Serum CA-125 and CA 19-9 were measured using immunoradiologic methods during the follicular phase preceding laparoscopy for infertility. Values obtained were correlated with the occurrence and severity of endometriosis. Receiver operating characteristic (ROC) curve was applied to assess the utility of serum CA-125, CA 19-9, and pain score in preoperative preparation. Cut-off value of CA-125 and CA 19-9 was defined. RESULTS: The study enrolled 294 infertile women receiving laparoscopy between July 2010 and September 2011. Ninety-four patients were diagnosed with endometriosis and 200 patients without. Preoperative serum CA-125 and CA 19-9 levels were significantly different between the two groups. ROC curve analyses of serum CA-125 and CA 19-9 set a cut-off value of 18.25 IU/ml and 13.15 IU/ml, producing a sensitivity of 64.8% and 84.8%, a specificity of 81.9% and 51.6%, a positive predictive value (PPV) of 63.6% and 46.1%, and a negative predictive value (NPV) of 81.0% and 87.4%, respectively. Combined-analyses of CA-125 and CA 19-9 produced a sensitivity of 72.4%, a specificity of 81.9%, a PPV of 62.3%, and a NPV of 81.8%. Combined-analyses of serum CA-125, CA 19-9 and pain score produced a sensitivity of 71.0% and a specificity of 74.0%. CONCLUSIONS: Preoperative CA-125 and CA 19-9 levels combining pain score can be useful for the prediction of pelvic endometrinsis and may he included in the evaluation of unexulained infertile women.
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Abstract

Objective: To define the utility of serum carcinogenic antigen (CA)-125 and CA 19-9 combining pain score in the prediction of pelvic endometriosis in infertile women. Materials and Methods: Serum CA-125 and CA 19-9 were measured using immunoradiologic methods during the follicular phase preceding laparoscopy for infertility. Values obtained were correlated with the occurrence and severity of endometriosis. Receiver operating characteristic (ROC) curve was applied to assess the utility of serum CA-125, CA 19-9, and pain score in preoperative preparation. Cut-off value of CA-125 and CA 19-9 was defined. Results: The study enrolled 294 infertile women receiving laparoscopy between July 2010 and September 2011. Ninety-four patients were diagnosed with endometriosis and 200 patients without. Preoperative serum CA-125 and CA 19-9 levels were significantly different between the two groups. ROC curve analyses ofserum CA-125 and CA 19-9 set a cut-off value of 18.25 IU/ml and 13.15 IU/ml, producing a sensitivity of 64.8% and 84.8%, a specificity of 81.9% and 51.6%, a positive predictive value (PPV) of 63.6% and 46.1%, and a negative predictive value (NPV) of 81.0% and 87.4%, respectively. Combined-analyses of CA-125 and CA 19-9 produced a sensitivity of 72.4%, a specificity of 81.9%, a PPV of 62.3%, and a NPV of 81.8%. Combined-analyses of serum CA-125, CA 19-9 and pain score produced a sensitivity of 71.0% and a specificity of 74.0%. Conclusions: Preoperative CA-125 and CA 19-9 levels combining pain score can be useful for the prediction of pelvicendometriosis and may be included in the evaluation of unexplained infertile women.

Keywords

- Carcinogenic antigen 125 - Carcinogenic antigen 19-9 - Endometriosis - Infertility - Pain score

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Condition tags

mesh:D004715mesh:D017699endometriosisinfertility

MeSH descriptors

CA-125 Antigen CA-19-9 Antigen Endometriosis Infertility, Female Pelvic Pain Adult CA-125 Antigen CA-19-9 Antigen Case-Control Studies Endometriosis Endometriosis Endometriosis Endometriosis Female Follicular Phase Humans Infertility, Female Infertility, Female Infertility, Female Laparoscopy

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