Daher R M F, Rosa-E-Silva J C, Poli-Neto O B, Candido-Dos-Reis F J, Nogueira A A
Clin Exp Obstet Gynecol. 2016;43(4):512-515.
To assess the accuracy of CA-125 determination associated with clinical history and of the neutrophil/lymphocyte (N/L) ratio for a presumptive diagnosis of endometriosis in women with chronic pelvic pain (CPP).
This was a cross-sectional study of data from the medical records of women with CPP submitted to laparoscopy from August 1999 to January 2009 at the University Hospital. The performance of the evaluation of CA-125 and of the N/L ratio for the prediction of endometriosis was compared based on the corresponding ROC curves and their 95% confidence intervals.
CA-125 levels were significantly higher in women with CPP and endometriosis and their association with a complaint of dysmenorrhea improved their sensitivity. For a cut-off of 20 IU/ml, the predictive value for a diagnosis of endometriosis in women with CPP was 97.6%. Dyspareunia, subfertility, and N/L ratio were not useful for a diagnosis of endometriosis in women with CPP.
The association of elevated CA-125 levels with a complaint of dysmenorrhea is adequate in a presumptive and accurate diagnosis of endometriosis in this specific group of women with CPP, permitting an early institution of clinical treatment without the need of previous laparoscopic confirmation.
评估CA - 125测定结合临床病史以及中性粒细胞/淋巴细胞（N/L）比值对慢性盆腔疼痛（CPP）女性子宫内膜异位症的初步诊断准确性。
这是一项横断面研究，数据来源于1999年8月至2009年1月在大学医院接受腹腔镜检查的CPP女性的病历。基于相应的ROC曲线及其95%置信区间，比较CA - 125评估和N/L比值对子宫内膜异位症预测的性能。
CPP合并子宫内膜异位症的女性CA - 125水平显著更高，且其与痛经主诉的关联提高了敏感性。对于20 IU/ml的临界值，CPP女性诊断子宫内膜异位症的预测值为97.6%。性交困难、不孕和N/L比值对CPP女性子宫内膜异位症的诊断无用。
在这一特定的CPP女性群体中，CA - 125水平升高与痛经主诉相结合，足以对子宫内膜异位症进行初步且准确的诊断，无需先前腹腔镜检查确认即可早期开展临床治疗。
