Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Ann Med. 2022 Dec;54(1):1444-1451. doi: 10.1080/07853890.2022.2074534.
To clarify clinical importance of serum CA19-9, CA-125, and plasma D-dimer (D-D) levels in detecting spontaneously ruptured ovarian endometriosis (OE).
We retrospectively examined 173 patients with endometriosis out of 735 cases of OE between 2013 and 2019. Among these, 21 cases were diagnosed as "spontaneously ruptured" after surgery, while the remaining cases were unruptured. Venous blood was collected pre-operatively to detect CA19-9, CA-125, and D-D levels. A receiver operating characteristic curve analysis was applied to test clinical value of each marker.
Among the 21 patients with ruptured OE, 16 had a history of pelvic cysts, 19 claimed sudden onsets of lower abdominal pain, and fluid accumulation were detected in cul-de-sac in only six participants by ultrasound. For serological investigation, both CA19-9 and D-D were significantly elevated in the ruptured OE group (343.09 ± 367.67 U/ml vs. 36.84 ± 40.01 U/ml, 3.39 ± 4.90 mg/L vs. 0.43 ± 0.29 mg/L, both < .0001). The area under curve (AUC) value for the combination of CA19-9 and D-D was 0.975 (95% CI, 0.939 - 0.993), with specificity of 96.69%, and sensitivity of 85.71%. The combination of CA-125, CA19-9 and D-D showed the highest AUC value that up to 0.976 (95% CI, 0.940-0.993), with sensitivity of 95.24%, and specificity of 87.50%.
The combination of CA19-9 and D-D can be chosen as an effective and economical indicators to identify patients with spontaneously ruptured OE in pre-operation assessment. However, from the perspective of differential diagnosis, the combination of CA-125, CA19-9 and D-D is the best choice. Key messagesTaking into account the economic effect, the combination of CA19-9 and D-D can be chosen as an effective indicators to identify patients with spontaneously ruptured OE in pre-operation assessment.From the perspective of differential diagnosis, the combination of CA-125, CA19-9 and D-D is the best choice to identify patients with spontaneously ruptured OE.
为了明确血清 CA19-9、CA-125 和血浆 D-二聚体（D-D）水平在检测自发性破裂卵巢子宫内膜异位症（OE）中的临床重要性。
我们回顾性检查了 2013 年至 2019 年间 735 例 OE 病例中的 173 例子宫内膜异位症患者。其中 21 例术后诊断为“自发性破裂”，其余病例未破裂。术前采集静脉血检测 CA19-9、CA-125 和 D-D 水平。应用受试者工作特征曲线分析测试各标志物的临床价值。
在 21 例破裂的 OE 患者中，16 例有盆腔囊肿病史，19 例诉下腹突然发作疼痛，仅 6 例患者超声检查发现盆腔积液。血清学检查发现，破裂的 OE 组中 CA19-9 和 D-D 均显著升高（343.09±367.67 U/ml 与 36.84±40.01 U/ml，3.39±4.90 mg/L 与 0.43±0.29 mg/L，均<.0001）。CA19-9 和 D-D 联合检测的曲线下面积（AUC）值为 0.975（95%可信区间，0.939-0.993），特异性为 96.69%，敏感性为 85.71%。CA-125、CA19-9 和 D-D 联合检测的 AUC 值最高，达到 0.976（95%可信区间，0.940-0.993），敏感性为 95.24%，特异性为 87.50%。
考虑到经济效应，CA19-9 和 D-D 联合检测可作为术前评估中识别自发性破裂 OE 患者的有效、经济指标。但从鉴别诊断的角度来看，CA-125、CA19-9 和 D-D 的联合检测是识别自发性破裂 OE 患者的最佳选择。
考虑到经济效应，CA19-9 和 D-D 联合检测可作为术前评估中识别自发性破裂 OE 患者的有效、经济指标。
从鉴别诊断的角度来看，CA-125、CA19-9 和 D-D 的联合检测是识别自发性破裂 OE 患者的最佳选择。
