Koninckx P R, Muyldermans M, Moerman P, Meuleman C, Deprest J, Cornillie F
Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Catholic University Leuven (KUL), Belgium.
Hum Reprod. 1992 Oct;7(9):1314-7. doi: 10.1093/oxfordjournals.humrep.a137847.
In a prospective study, the concentrations of CA 125, 17 beta-oestradiol and progesterone were assayed in 52 consecutive ovarian cysts, laparoscopically suspected to be endometriomas. Cysts with dark brown 'chocolate' fluid (n = 42) were excised by CO2-laser endoscopy. Cysts with clear fluid were diagnosed by pathology as follicular cysts (n = 5) or pseudoperitoneal cysts (n = 5). Fluids (n = 53) aspirated during echo-guided puncture for in-vitro fertilization (IVF) were assayed simultaneously. Of the 42 women undergoing a cystectomy, the clinical diagnosis of an endometrioma was confirmed by pathology in only 68%, the other cases being corpora lutea (27%) or follicular cysts (5%). Cyst fluids from corpora lutea had lower CA 125 concentrations (< 1000 IU/ml) together with high 17 beta-oestradiol concentrations (> 2000 pg/ml) and/or high progesterone concentrations (> 100 ng/ml). Endometriotic cysts had either very high CA 125 concentrations (> 10,000 IU/ml) as occurred in 78% or lower CA 125 concentrations (< 1000 IU/ml) together with low 17 beta-oestradiol and/or progesterone concentrations. 'Chocolate' fluid-containing cysts aspirated during IVF had similar concentration profiles of CA 125, 17 beta-oestradiol and progesterone and the diagnoses derived from these concentrations were not contradicted in 19/27 women undergoing a laparoscopy within 4 months. In eight women, however, with high CA 125 concentrations in their cyst fluid, no endometriotic cysts were found at laparoscopy. Only 68% of cysts containing 'chocolate' material were endometriotic cysts and CA 125 could be useful in making this diagnosis. This method is recommended when dark brown fluid is aspirated in IVF.
在一项前瞻性研究中，对52例经腹腔镜检查怀疑为子宫内膜异位囊肿的连续卵巢囊肿患者检测了CA 125、17β-雌二醇和孕酮的浓度。通过二氧化碳激光内镜切除含有深褐色“巧克力”样液体的囊肿（n = 42）。病理诊断为清亮液体的囊肿为滤泡囊肿（n = 5）或假性腹膜囊肿（n = 5）。同时检测了在超声引导下经皮穿刺取卵用于体外受精（IVF）时抽取的液体（n = 53）。在接受囊肿切除术的42例女性中，病理证实仅68%为子宫内膜异位囊肿，其他病例为黄体囊肿（27%）或滤泡囊肿（5%）。黄体囊肿的囊液CA 125浓度较低（<1000 IU/ml），同时17β-雌二醇浓度较高（>2000 pg/ml）和/或孕酮浓度较高（>100 ng/ml）。子宫内膜异位囊肿要么CA 125浓度非常高（>10,000 IU/ml），这种情况占78%，要么CA 125浓度较低（<1000 IU/ml），同时17β-雌二醇和/或孕酮浓度较低。IVF期间抽取的含“巧克力”样液体的囊肿，其CA 125、17β-雌二醇和孕酮的浓度分布相似，在4个月内接受腹腔镜检查的27例女性中，19例根据这些浓度做出的诊断与实际情况相符。然而，在8例囊肿液CA 125浓度高的女性中，腹腔镜检查未发现子宫内膜异位囊肿。仅68%含“巧克力”样物质的囊肿为子宫内膜异位囊肿，CA 125有助于做出该诊断。当在IVF中抽取到深褐色液体时，推荐使用此方法。
