The Journal of Minimally Invasive Gynecology
Volume 14, Issue 2 , Pages 223-227, March 2007

Correlation between serum levels of CA 125 and follicular loss after laparoscopic cystectomy in women with ovarian endometrioma

  • Mario Vicino, MD

      Affiliations

    • Departments of Obstetrics and Gynecology, University of Bari, Bari, Italy.
    • ,
  • Leonardo Resta, MD

      Affiliations

    • Department of Pathological Anatomy and Genetics, University of Bari, Bari, Italy.
    • ,
  • Marco Scioscia, MD

      Affiliations

    • Departments of Obstetrics and Gynecology, University of Bari, Bari, Italy.
    • Corresponding Author InformationCorresponding author: Dr. Marco Scioscia, Department of Obstetrics and Gynaecology, University of Bari, Policlinico di Bari, Piazza Giulio Cesare 11, 70125 Bari, Italy.
    • ,
  • Andrea Marzullo, MD

      Affiliations

    • Department of Pathological Anatomy and Genetics, University of Bari, Bari, Italy.
    • ,
  • Oronzo Ceci, MD

      Affiliations

    • Departments of Obstetrics and Gynecology, University of Bari, Bari, Italy.
    • ,
  • Stefano Bettocchi, MD

      Affiliations

    • Departments of Obstetrics and Gynecology, University of Bari, Bari, Italy.

Received 10 June 2006; accepted 7 October 2006.

Abstract 

Study objective

To preoperatively predict follicular loss after laparoscopic cystectomy of ovarian endometriomas.

Design

Case-control study. (Canadian Task Force classification II-2).

Setting

University hospital.

Patients

Seventy-six women with ovarian endometrioma and 41 patients with nonendometriotic ovarian cysts who underwent laparoscopy.

Interventions

Sonographic findings and serum levels of CA 125 and CA 19.9 were recorded.

Measurements and main results

Considered parameters were compared with a histologic score, on the basis of the presence and morphologic features of follicles on the normal ovarian tissue adjacent to the cyst wall surgically removed. Serum levels of CA 125 and CA 19.9 were increased in patients with ovarian endometrioma (p <.001 and p <.01, respectively). Capsule wall thickness, presence of fibrosis, and follicles in the tissue surrounding the capsule were significantly increased in the study group (p <.01). CA 125 serum level was directly correlated to the histologic score (r = 0.46, p <.05) and to cyst diameter (r = 0.12, p = .01), whereas no correlation was found between CA 19.9 or cyst diameter and follicular score.

Conclusions

Our data suggest that the ovarian tissue inadvertently removed along with the endometrioma wall by laparoscopic stripping is due to pericystic fibrosis. Serum levels of CA 125 represent a useful parameter to predict follicular loss before surgery.

Keywords: Endometrioma, Follicular loss, Laparoscopic cystectomy, Histologic study

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 The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

PII: S1553-4650(06)00544-9

doi:10.1016/j.jmig.2006.10.002

The Journal of Minimally Invasive Gynecology
Volume 14, Issue 2 , Pages 223-227, March 2007

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