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The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis
B W Mol1, N Bayram, J G Lijmer
1Department of Obstetrics and Gynecology, St. Joseph Hospital, Veldhoven, The Netherlands. bwmol@knmg.nl
Objective:
To assess the diagnostic performance of serum CA-125 measurement in the detection of endometriosis.
Design:
Meta-analysis.
Setting And Patient(S):
Twenty-three studies comparing serum CA-125 levels and laparoscopically confirmed endometriosis.
Intervention(S):
Serum CA-125 measurement and laparoscopy.
Main Outcome Measure(S):
Sensitivity and specificity of serum CA-125 measurement in the diagnosis of endometriosis with laparoscopy as the reference standard.
Result(S):
The estimated summary receiver operating characteristic curves showed that the performance of serum CA-125 measurement in the diagnosis of endometriosis grade I/IV is limited, whereas its performance in the diagnosis of endometriosis grade III/IV is better.
Conclusion(S):
Despite its limited diagnostic performance, we believe that the routine use of serum CA-125 measurement in patients with infertility might be justified. In contrast to laparoscopy, serum CA-125 measurement is an inexpensive test that is not a burden for the patient. It could identify a subgroup of patients who are more likely to benefit from early laparoscopy. Studies reporting on the mutual dependence between serum CA-125 measurement and data from the history and physical examination are needed.
