The value of serum CA 125 for the management of tubo-ovarian abscesses.

OBJECTIVE: The aim of this study was to compare the value of CA 125, ESR and CRP in predicting the outcome of tubo-ovarian abscess (TOA) treatment and to investigate whether TOA treatment could be improved by following the dynamics of CA 125 serum levels.

STUDY DESIGN: This prospective study included 36 patients with unilateral TOA, confirmed on the basis of history and physical examination, laboratory findings, and ultrasound (US) investigation. Venous blood samples for estimation of serum CA 125, CRP, and ESR were taken on hospital admission and then every 5 days. On day 20, the success of treatment was evaluated by clinical and sonographical re-assessment, and the patients were divided into two groups: those with complete regression of the TOA and those with residual inflammatory disease. Statistical analysis was performed by nonparametric Mann-Whitney U-test with multiple regression.

RESULTS: On admission, CA 125 levels were increased (> 16.7 U/ml) in 32 patients (88.9%). The CA 125 level amounted to 55.7 U/ml on the average. A significant difference in CA 125 values between the above mentioned two groups was observed from day 10 of treatment onwards (p = 0.00015). On comparison of ESR, CRP, and CA 125, the latter had the highest predictive value for disease outcome after day 10 (p < 0.0011), while at the time of diagnosis, ESR proved more reliable in predicting the outcome.

CONCLUSIONS: The dynamics of serum CA 125 allow an objective evaluation of the course and outcome of TOA, in combination with clinical parametres and US investigation.