Background: To investigate the relationships of cancer antigen (CA) 125, CA 19-9, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), fibrinogen (FIB), and D-dimer values with ovarian endometriosis (OEM), and to explore the validation of biomarkers for noninvasive preoperative evaluation of patients with severe OEM.
Methods: This retrospective case-control study included 413 women with OEM (of whom 143 cases were stage I to II, 139 cases were stage III, and 131 cases were stage IV, respectively) and 158 women without OEM as controls. Subjects' serum CA-125 and CA19-9 levels, and coagulation test results (serum PT, aPTT, and D-dimer values) were evaluated.
Results: The serum CA-125, aPTT, FIB and D-dimer levels were statistically different between OEM patients in the stages I to (and) II group and those in the stages III and IV group (P<0.05). However, a statistical difference in CA 19-9 levels and TT was only found between patients with stages III and IV OEM. In receiver operating characteristic (ROC) curve analysis of single indexes, the area under the ROC curve values for CA-125, CA19-9, aPTT, TT, FIB, and D-dimer were 0.953, 0.512, 0.66, 0.576, 0.573, and 0.624, respectively, for diagnosing stage III and stage IV OEM. In ROC curve analysis of combined indexes, the AUC values for aPTT + D-dimer, CA-125 + D-dimer, CA-125 + aPTT and CA-125 + D-dimer + aPTT were 0.672, 0.954, 0.958, and 0.961, respectively.
Conclusions: The combined index of CA-125, aPTT, and D-dimer is a valid noninvasive preoperative method for the evaluation of moderate and severe OEM, and may help to decrease the interval between the first complaint and a definitive diagnosis.
Keywords: Cancer antigen-125 (CA-125); D-dimer; activated partial thromboplastin time (aPTT); cancer antigen 19-9 (CA19-9); endometriosis; fibrinogen (FIB); noninvasive evaluation; prothrombin time (PT); thrombin time (TT).