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Korean Journal of Obstetrics & Gynecology 2008;51(4):448-457.
Published online April 1, 2008.
The value of serum CA 125 in tubo-ovarian abscess.
In Suk Shim, Hye Won Chung, Jung Ja Ahn, Hye Sung Moon
Department of Obstetrics and Gynecology, University School of Medicine, Ewha Woman's University, Seoul, Korea. mhsmhs@ewha.ac.kr
Abstract
OBJECTIVE
The aim of this study is to measure the serum levels of CA 125, ESR and CRP in patients with tubo-ovarian abscess (TOA) before and after treatment of abscess and to assess the usefulness of CA 125 in the diagnosis, prediction of the outcome of TOA treatment and clinical follow-up of patient's condition. METHODS: This retrospective study included 65 patients with TOA. Serum CA 125, ESR, CRP and WBC counts were measured. The treatment was done conservatively with antibiotics. The patients were divided into two groups: those with successful results into group 1 (29 cases) and those with unsuccessful results into group 2 (36 cases). If treatment was considered to be unsuccessful, surgical intervention was additionally performed. RESULTS: The serum levels of CA 125, ESR and abscess size on admission in group 2 were significantly higher than in group 1. ESR, abscess size and CA 125 in order were valuable predictive factors affecting the success of medical treatment. And the new cutoff value was 36.5 mm/h, 4.2 cm and 68.3 U/ml, respectively. The sensitivity rate of CA 125, ESR levels was significantly higher in group 2 than in group 1. Although CRP was decreased significantly 10 days after treatment, the serum CA 125 was not decreased significantly. And it took 51.5 days for CA 125 to be normalized after the initiation of treatment. CONCLUSIONS: The serum CA125, ESR levels and abscess sizes are predictive factors affecting the success of medical treatment of abscess treatment. And CA 125 and ESR are useful for diagnosing severity of disease. But serum CA 125 level is an inappropriate marker for monitoring short-term efficacy of treatment.
Key Words: Tubo-ovarian abscess (TOA), CA 125, ESR, CRP


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