Monitoring parameters in the management of patients with tubo-ovarian complexes

The aim of the study was to determine which of the monitored parameters is most suitable for following the treatment of tubo-ovarian complex (TOC).

In 35 patients treated conservatively for TOC, serum levels of C-reactive protein (CRP), erytrocyte sedimentation rate (ESR) and tumor-associated antigen 125 (CA-125) were determined at the beginning as well as on days 5, 10, 15 and 20 of treatment. TOC size was measured ultrasonographically prior to and on day 20 of treatment. We compared the dynamics of these parameters. Spearman's correlation test was used to establish the connection between levels of CRP, ESR, CA-125 and the size of the TOC.

CRP follows the course of acute inflammation quickly, ESR and CA-125 with some delay. The correlation between the size of the tumor on admission and the CRP levels was established on days 5-10, ESR from the beginning until day 15 and the CA-125 levels on days 10-20 of treatment. On day 20, only the levels of CA-125 correlated with the size of the TOC measured on the same day (R = 0.49, P = 0.01) and only the difference between its levels correlated with the difference in TOC (R = 0.41, P = 0.01).

Determination of CRP, and somewhat less ESR, is more suitable for following the treatment of TOC in the acute phase while CA-125 and measuring of TOC size is more suitable in the subacute phase.