Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):262-267
DOI 10.1590/S0100-72032013000600005
PURPOSE: To correlate preoperative serum cancer antigen 125 (Ca-125) levels and laparoscopic findings in women with pelvic pain symptoms suggestive of endometriosis. METHODS: A retrospective study was conducted including all women with pelvic pain symptoms suspected for endometriosis operated by laparoscopy from January 2010 to March 2013. Patients were divided into 2 groups according to preoperative Ca-125 level (<35 U/mL and >35 U/mL). Subsequently, patients with ovarian endometriomas were excluded and a further analysis was conducted again according to the preoperative Ca-125 level. The following parameters were compared between groups: presence of ovarian endometrioma, presence and number of deep infiltrating endometriosis (DIE) lesions and American Society for Reproductive Medicine score. The statistical analysis was performed with Statistica version 8.0, using the Fisher exact test, Student's t-test and Mann-Whitney test, when needed. A p value of <0.05 was considered to be statistically significant. RESULTS: During the study period, a total of 350 women were submitted to laparoscopic treatment of endometriosis. One hundred thirty patients (37.1%) had Ca-125>35 U/mL and 220 (62.9%) had Ca-12<35 U/mL. The presence of ovarian endometriomas (47.7 versus 15.9%), DIE lesions (99.6 versus 78.6%) and intestinal DIE lesions (60 versus 30.9%) was more frequent, and the AFSr score was higher (34 versus 6) in the former group. In the second analysis, excluding the patients with ovarian endometriomas (>35 U/mL=68 patients and <35 U/mL=185 patients), similar results were obtained. The presence of DIE lesions (91.2 versus 76.2%), intestinal DIE lesions (63.2 versus 25.4%), bladder DIE lesions (20.6 versus 4.8%) and ureteral DIE lesions (7.3 versus 1.6%) was more frequent, and the AFSr score was higher (10 versus 6) in the Ca-125 >35 U/mL group. CONCLUSIONS: Investigation for DIE is mandatory in women with pelvic pain symptoms suggestive of endometriosis with a preoperative Ca-125 level >35 U/mL, especially when an ovarian endometrioma is not present.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(2):91-95
DOI 10.1590/S0100-72031998000200006
Predicting pregnancy outcome from one or more maternal serum factors has been the subject of numerous investigations with controversial results. The aim of this study was to evaluate the serum levels of CA-125, CA-19.9, CA-15.3, beta-hCG, estradiol, progesterone, alpha-fetoprotein and CEA in women with abortion (n=18) and with pregnancy complicated by bleeding (n=6), in comparison to the serum levels of the control group (n=7). The results showed that the serum levels of CA-125 were significantly increased in the abortion group (153.9 ± 43.3 IU/ml), but no difference was detected in pregnancy complicated by bleeding (17.4 ± 2.6 IU/ml), as compared to control (24.7 ± 13.4 IU/ml). However, high serum levels of CA-19.9 were found in the group with pregnancy complicated by bleeding in comparison with the abortion group (20.2 ± 11.4 IU/ml versus 6.6 ± 1.4 IU/ml, respectively). In relation to hormone serum levels, both, the abortion (17.38 ± 9.4 ng/ml) and bleeding (18.3 ± 8.9 ng/ml) groups showed lower serum levels of progesterone, as compared to control (60.4 ± 26.8 ng/ml). Besides, women with abortion had additional low estradiol serum levels, when compared to controls (1,327 ± 1,015 ng/ml versus 10,774 ± 9,244 ng/ml). It was concluded that the serum levels of progesterone, CA-19.9 and beta-hCG seem to add valuable information to the evaluation of a pregnancy complicated by bleeding.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):345-351
DOI 10.1590/S0100-72032003000500007
PURPOSE: to estimate the sensitivity, specificity and accuracy of patient age, ultrasound result and CA-125 marker variables for the differential diagnosis between malignant and benign ovarian tumors. In addition, to establish a risk of malignancy index (RMI) incorporating these three variables and to estimate its sensitivity, specificity and accuracy for the differential diagnosis. METHODS: one hundred patients with ovarian tumors with surgical indication were included. The age, ultrasonographic findings and CA-125 level variables were evaluated separately and later on together as the RMI. The study was performed based on the evaluation of the sensitivity, specificity and diagnostic accuracy and the use of the measurements: likelihood ratio, odds ratio, and the Student's t test, chi², and logistic regression with univariate and multivariate analysis. RESULTS: for the age variable, sensitivity, specificity and diagnostic accuracy were 58.8, 68.2 and 65.0%, respectively. For ultrasound, 88.2, 77.3 and 81.0%. For CA-125 dosage, the values were 64.7, 74.2 and 71.0%. When the three variables were put together, as the RMI, a sensitivity of 76.5%, a specificity of 87.9% and a diagnostic accuracy of 84.0% were observed. CONCLUSIONS: RMI, made up of the association of patient age, ultrasound results and CA-125 dosage variables is a valuable indicator to distinguish between malignant and benign ovarian tumor, especially in regard to its specificity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(8):525-528
DOI 10.1590/S0100-72032000000800009
Pelvic tuberculosis is an extrapulmonary form of tuberculosis with increasing incidence in the western world. Clinical and laboratory findings of this disease are often unspecific and mimic a variety of other disorders, including gynecologic malignant tumors. The authors report a case of a 53-year-old woman with pelvic tuberculosis and associated abdominal tuberculous peritonitis. Laboratory investigation included laparoscopy, CA-125 levels and tuberculin test, among others. Discussion on the clinicopathological aspects and diagnostic methods used to elucidate this case is presented.