Barbosa Caio Parente, Souza Angela Mara Bentes de, Bianco Bianca, Christofolini Denise, Bach Fernanda Abani Mafra, Lima Geraldo Rodrigues de
Division of Pathological Gynecology, Department of Gynecology and Obstetrics, Faculdade de Medicina do ABC, Santo André, São Paulo.
Sao Paulo Med J. 2009 Nov;127(6):342-5. doi: 10.1590/s1516-31802009000600004.
Serological testing for CA125 has been widely used to detect endometriosis and to monitor its progression. However, controversy still exists regarding the usefulness of the plasma CA125 assay for diagnosing endometriosis. Furthermore, some authors have described superficial endometriosis as a cyclical and normal phenomenon in women's lives, and have indicated that development and progression of this disease would only occur in some women as a result of immunological changes. This study aimed to determine the frequency of endometriosis and the correlation between serum CA125 levels and the presence of endometriotic lesions in the peritoneum of asymptomatic fertile patients.
Cross-sectional study at the Family Planning outpatient clinic of Faculdade de Medicina do ABC.
Eighty asymptomatic fertile patients who underwent tubal sterilization surgery were studied. Blood and peritoneum samples were collected. CA125 levels were measured from blood samples, and peritoneum biopsies were studied using histopathological tests.
Histopathological evaluation of the peritoneum revealed that 16.25% of the patients had minimal or mild endometriosis. There was no statistically significant difference in CA125 levels between patients with and without endometriosis.
The presence of endometriotic lesions in the peritoneum of fertile patients supports the hypothesis that incidental findings of minimal or mild endometriosis may not be of clinical significance, and that the progression of the disease probably occurs as a result of immunological and genetic abnormalities. Serum CA125 levels did not show any diagnostic significance with regard to detecting the disease.
CA125血清学检测已广泛用于子宫内膜异位症的检测及病情监测。然而,血浆CA125检测对子宫内膜异位症诊断的有用性仍存在争议。此外,一些作者将浅表性子宫内膜异位症描述为女性生活中的一种周期性且正常的现象,并指出该疾病的发生和进展仅在部分女性中因免疫变化而出现。本研究旨在确定无症状可育患者中子宫内膜异位症的发生率以及血清CA125水平与腹膜子宫内膜异位症病灶存在之间的相关性。
在ABC医学院计划生育门诊进行的横断面研究。
对80例行输卵管绝育术的无症状可育患者进行研究。采集血液和腹膜样本。检测血液样本中的CA125水平,并通过组织病理学检查研究腹膜活检样本。
腹膜的组织病理学评估显示,16.25%的患者有轻微或轻度子宫内膜异位症。有和没有子宫内膜异位症的患者之间CA125水平无统计学显著差异。
可育患者腹膜中存在子宫内膜异位症病灶支持了以下假设,即轻微或轻度子宫内膜异位症的偶然发现可能无临床意义,且该疾病的进展可能是免疫和基因异常所致。血清CA125水平在检测该疾病方面未显示出任何诊断意义。