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

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 produ(c)ed 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 endometriosis and may be included in the evaluation of unexplained infertile women.