Koninckx P R, Riittinen L, Seppala M, Cornillie F J
Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Leuven, Belgium.
Fertil Steril. 1992 Mar;57(3):523-30.
To investigate the plasma and peritoneal fluid (PF) concentrations of CA-125 and placental protein (PP14) in women with deeply infiltrating endometriosis.
Plasma and PF were collected during 384 consecutive laparoscopies for pelvic pain or infertility.
The presence and extent of endometriosis were carefully assessed, including the area, depth of infiltration, and volume of subtle lesions, typical lesions, and endometriomas. The day of the menstrual cycle was ascertained by endometrial biopsy and/or basal body temperature charts.
Peritoneal fluid concentrations were some 100 and 10 times higher than plasma concentrations for CA-125 and PP14, respectively. Cyclic variations of CA-125 concentrations were only found in women with endometriosis showing increased plasma concentrations at the end of the cycle and increased PF concentrations in the early follicular phase. Cyclic variations of PP14 concentrations were found in women with and without endometriosis both in plasma and PF showing increased concentrations in the late luteal and early follicular phases. In women with endometriosis the increased plasma concentrations of PP14 and CA-125 correlated with the presence and volume of endometriomas and of deeply infiltrating endometriosis. The increased concentrations in PF correlated only with the pelvic area of subtle endometriotic lesions. The diagnostic sensitivity and specificity of CA-125 for endometriosis were 25% and 87%, respectively, and for endometriomas and/or deeply infiltrating endometriosis 36% and 87%, respectively, for a cutoff concentration of 25 U/mL.
Superficial pelvic endometriosis secretes PP14 and CA-125 mainly toward the PF, whereas endometriomas and deeply infiltrating endometriosis secrete mainly toward the plasma. The increased plasma concentrations of CA-125 are most pronounced during the late luteal phase, and endometriomas and/or deeply infiltrating endometriosis can be detected with a sensitivity of 36% and a specificity of 87%.
研究深部浸润型子宫内膜异位症患者血浆及腹腔液中CA - 125和胎盘蛋白（PP14）的浓度。
在连续384例因盆腔疼痛或不孕而接受腹腔镜检查的患者中采集血浆和腹腔液。
仔细评估子宫内膜异位症的存在及程度，包括微小病变、典型病变和子宫内膜瘤的面积、浸润深度及体积。通过子宫内膜活检和/或基础体温图确定月经周期的日期。
腹腔液中CA - 125和PP14的浓度分别比血浆浓度高约100倍和10倍。仅在患有子宫内膜异位症的女性中发现CA - 125浓度的周期性变化，表现为周期末期血浆浓度升高，卵泡早期腹腔液浓度升高。在有和没有子宫内膜异位症的女性中均发现PP14浓度的周期性变化，血浆和腹腔液中均表现为黄体晚期和卵泡早期浓度升高。在患有子宫内膜异位症的女性中，PP14和CA - 125血浆浓度升高与子宫内膜瘤及深部浸润型子宫内膜异位症的存在和体积相关。腹腔液中浓度升高仅与微小子宫内膜异位病变的盆腔面积相关。CA - 125诊断子宫内膜异位症的敏感性和特异性分别为25%和87%，诊断子宫内膜瘤和/或深部浸润型子宫内膜异位症的敏感性和特异性分别为36%和87%，临界浓度为25 U/mL。
盆腔浅表性子宫内膜异位症主要向腹腔液分泌PP14和CA - 125，而子宫内膜瘤和深部浸润型子宫内膜异位症主要向血浆分泌。CA - 125血浆浓度升高在黄体晚期最为明显，检测子宫内膜瘤和/或深部浸润型子宫内膜异位症的敏感性为36%，特异性为87%。
