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BioMed Research International
Volume 2017, Article ID 9857196, 6 pages
Research Article

How to Use CA-125 More Effectively in the Diagnosis of Deep Endometriosis

Department of Gynecology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

Correspondence should be addressed to Marco Aurelio Pinho Oliveira; moc.liamg@esoirtemodne

Received 13 February 2017; Accepted 8 May 2017; Published 4 June 2017

Academic Editor: Ivo Meinhold-Heerlein

Copyright © 2017 Marco Aurelio Pinho Oliveira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Deep infiltrative endometriosis (DIE) is a severe form of the disease. The median time interval from the onset of symptoms to diagnosis of endometriosis is around 8 years. In this prospective study patients were divided into two groups: cases (34 DIE patients) and control (20 tubal ligation patients). The main objective of this study was to evaluate the performance of CA-125 measurement in the menstrual and midcycle phases of the cycle, as well as the difference in its levels between the two phases, for the early diagnosis of DIE. Area Under the Curve (AUC) of CA-125 in menstrual phase and of the difference between menstrual and midcycle phases had the best performance (both with AUC = 0.96), followed by CA-125 in the midcycle (AUC = 0.89). The ratio between menstrual and midcycle phases had the worst performance. CA-125 may be useful for the diagnosis of deep endometriosis, especially when both are collected during menstruation and in midcycle. These may help to decrease the long interval until the definitive diagnosis of DIE. Multicentric studies with larger samples should be performed to better evaluate the cost-effectiveness of measuring CA-125 in two different phases of the menstrual cycle.