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. 2009 Nov;127(6):342-5.
doi: 10.1590/s1516-31802009000600004.

Frequency of endometriotic lesions in peritoneum samples from asymptomatic fertile women and correlation with CA125 values

Caio Parente Barbosa  1 , Angela Mara Bentes de Souza, Bianca Bianco, Denise Christofolini, Fernanda Abani Mafra Bach, Geraldo Rodrigues de Lima
Affiliations

Frequency of endometriotic lesions in peritoneum samples from asymptomatic fertile women and correlation with CA125 values

Caio Parente Barbosa et al. Sao Paulo Med J. 2009 Nov.

Abstract
in English, Portuguese

Context and objective: Serological testing for CA125 has been widely used to detect endometriosis and to monitor its progression. However, controversy still exists regarding the usefulness of the plasma CA125 assay for diagnosing endometriosis. Furthermore, some authors have described superficial endometriosis as a cyclical and normal phenomenon in women's lives, and have indicated that development and progression of this disease would only occur in some women as a result of immunological changes. This study aimed to determine the frequency of endometriosis and the correlation between serum CA125 levels and the presence of endometriotic lesions in the peritoneum of asymptomatic fertile patients.

Design and setting: Cross-sectional study at the Family Planning outpatient clinic of Faculdade de Medicina do ABC.

Methods: Eighty asymptomatic fertile patients who underwent tubal sterilization surgery were studied. Blood and peritoneum samples were collected. CA125 levels were measured from blood samples, and peritoneum biopsies were studied using histopathological tests.

Results: Histopathological evaluation of the peritoneum revealed that 16.25% of the patients had minimal or mild endometriosis. There was no statistically significant difference in CA125 levels between patients with and without endometriosis.

Conclusion: The presence of endometriotic lesions in the peritoneum of fertile patients supports the hypothesis that incidental findings of minimal or mild endometriosis may not be of clinical significance, and that the progression of the disease probably occurs as a result of immunological and genetic abnormalities. Serum CA125 levels did not show any diagnostic significance with regard to detecting the disease.

CONTEXTO E OBJETIVO:: O teste sorológico para CA125 tem sido largamente usado para detectar e monitorar a progressão da endometriose, entretanto, a utilidade do ensaio do CA125 plasmático para o diagnóstico da endometriose ainda é controversa. Além disso, alguns autores descreveram a endometriose superficial como sendo um fenômeno cíclico e normal na vida de uma mulher, e que o desenvolvimento e progressão desta doença ocorreriam apenas em algumas mulheres como resultado de alterações imunológicas. Este estudo teve como objetivo determinar a freqüência de endometriose e a correlação entre os níveis séricos de CA125 e a presença de lesões endometrióticas em peritônio de pacientes férteis assintomáticas.

TIPO DE ESTUDO E LOCAL:: Estudo transversal realizado no Ambulatório de Planejamento Familiar da Faculdade de Medicina do ABC.

MÉTODOS:: Foram estudadas 80 pacientes férteis assintomáticas submetidas à cirurgia de esterilização tubária. Amostras de sangue e peritônio foram coletadas. Os níveis de CA125 foram medidos a partir das amostras de sangue e as biópsias de peritônio foram estudadas por ensaio histopatológico.

RESULTADOS:: O estudo histopatológico do peritônio revelou que 16,25% das pacientes apresentavam endometriose mínima e leve. Os níveis de CA125 não demonstraram diferença estatística significante entre pacientes com e sem endometriose.

CONCLUSÃO:: A presença de lesões endometrióticas em peritônio de pacientes férteis reforça a hipótese de que achados acidentais de endometriose mínima e leve podem não ter significância clínica, e que é provável que a progressão da doença ocorra como resultado de alterações genéticas e imunológicas. Os níveis séricos de CA125 não demonstraram significância diagnóstica para a detecção da doença.

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Conflict of interest statement

Conflict of interest: Not declared

Figures

Figure 1.
Figure 1.. Photomicrographs at 100 X (A) and 400 X (B and C) of histological findings from peritoneum of asymptomatic fertile patients showing endometriosis (A and B), compared with normal tissue (C) (hematoxylin-eosin staining).
See this image and copyright information in PMC

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