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. 2005 Jul;20(7):1999-2003.
doi: 10.1093/humrep/deh890. Epub 2005 May 12.

Usefulness and limits of CA-125 in diagnosis of endometriosis without associated ovarian endometriomas

Jo Kitawaki  1 , Hiroaki Ishihara, Hisato Koshiba, Miyo Kiyomizu, Mariko Teramoto, Yui Kitaoka, Hideo Honjo
Affiliations

Usefulness and limits of CA-125 in diagnosis of endometriosis without associated ovarian endometriomas

Jo Kitawaki et al. Hum Reprod. 2005 Jul.

Erratum in

  • Hum Reprod. 2007 Feb;22(2):627

Abstract

Background: The aim of this study was to evaluate the diagnostic significance of CA-125 for endometriosis without ovarian endometriomas.

Methods: Preoperative serum CA-125 levels were measured in 775 consecutive women diagnosed by laparoscopy or laparotomy with endometriosis, adenomyosis, leiomyomas, or normal pelvis.

Results: Receiver operating characteristic curve analysis revealed that the area under the curve for endometriosis without endometriomas was 0.788, significantly smaller than that for endometriosis with endometriomas (0.935, P < 0.05). In diagnosis of endometriosis without endometriomas, both the maximal accuracy of 78.8% and the maximal diagnostic value of 61.2% were obtained at the cutoff value of 20 U/mL. Negative predictive value was 78.0% at the cutoff value of 20 U/mL, whereas positive predictive value was 92.9% at the cutoff value of 30 U/mL. This range is clearly superior to the empirical single cutoff of 35 U/mL.

Conclusions: In the diagnosis of endometriosis without endometriomas, combined use of two cutoff values for CA-125, 20 and 30 U/mL, provides improved diagnostic performance. However, the accuracy of using only CA-125 testing for diagnosis is still limited. Serum CA-125 testing can be done during initial screenings of women with possible endometriosis.

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