O'Shaughnessy A, Check J H, Nowroozi K, Lurie D
Department of Obstetrics and Gynecology, Cooper Hospital/University Medical Center, Robert Wood Johnson Medical School, Camden, New Jersey.
Obstet Gynecol. 1993 Jan;81(1):99-103.
To examine variations in CA 125 levels during the three phases of the menstrual cycle in women with and without endometriosis.
One hundred infertile women were studied prospectively. CA 125 levels were measured during menses and during the follicular and luteal phases before diagnostic laparoscopy. Subjects were divided into four groups: no evidence of endometriosis (35 women), stage I endometriosis (30 women), stage II endometriosis (21 women), and stages III and IV endometriosis (14 women).
In the endometriosis groups, there was a significant difference in the mean CA 125 levels drawn at menses and those drawn in the follicular phase. In patients with severe endometriosis, there was also a difference in the mean CA 125 levels drawn at menses and in the luteal phase. This finding led to the development of a screening test based on the ratio of CA 125 levels at menses to levels in the follicular phase. The test based on this ratio (with a cutoff of 1.5) had a sensitivity of 62.5% and specificity of 75%, compared with a sensitivity of 26.8% and specificity of 100% for the test based on a single CA 125 level drawn at menses (with a cutoff of 35 U/mL).
CA 125 levels during menses are elevated compared with those during the follicular phase in patients with endometriosis. Screening tests based on the relationship of multiple CA 125 levels taken throughout the menstrual cycle were more sensitive for detection of endometriosis than tests based on a single CA 125 level.
研究有无子宫内膜异位症的女性在月经周期三个阶段中CA 125水平的变化。
对100名不孕女性进行前瞻性研究。在诊断性腹腔镜检查前，于月经期、卵泡期和黄体期测量CA 125水平。研究对象分为四组：无子宫内膜异位症证据组（35名女性）、I期子宫内膜异位症组（30名女性）、II期子宫内膜异位症组（21名女性）以及III期和IV期子宫内膜异位症组（14名女性）。
在子宫内膜异位症组中，月经期抽取的平均CA 125水平与卵泡期抽取的平均CA 125水平存在显著差异。在重度子宫内膜异位症患者中，月经期抽取的平均CA 125水平与黄体期抽取的平均CA 125水平也存在差异。这一发现促使基于月经期CA 125水平与卵泡期水平之比开发了一种筛查试验。基于该比值的试验（临界值为1.5）的敏感性为62.5%，特异性为75%，而基于月经期抽取的单一CA 125水平（临界值为35 U/mL）的试验敏感性为26.8%，特异性为100%。
与卵泡期相比，子宫内膜异位症患者月经期的CA 125水平升高。基于整个月经周期多次CA 125水平关系的筛查试验比基于单一CA 125水平的试验对子宫内膜异位症的检测更敏感。
