Association of Serum CA-125 Levels with Ovarian Tumors, Endometriosis, and Pelvic Inflammatory Disease

Open Access

Abstract

Background: Cancer antigen-125 (CA-125) is a widely recognized biomarker used in the assessment of ovarian malignancies. However, elevated CA-125 levels are also observed in several benign gynecological conditions, including endometriosis and pelvic inflammatory disease (PID), which may reduce its diagnostic specificity. Objective: To evaluate serum CA-125 levels in women with ovarian tumors, endometriosis, and PID and determine its diagnostic significance in differentiating malignant from benign pelvic conditions. Methods & Materials: This cross-sectional analytical study was conducted from January to December 2024 at the Department of Obstetrics and Gynecology, Gazi Medical College Hospital, Khulna, Bangladesh. A total of 160 women aged 18-70 years were enrolled and divided into four groups: ovarian tumors (n=60), endometriosis (n=40), PID (n=30), and healthy controls (n=30). Diagnoses were established through clinical examination, imaging studies, and histopathology where applicable. Serum CA-125 levels were measured using chemiluminescent immunoassay, with values >35 U/mL considered elevated. Results: Mean serum CA-125 levels were significantly higher in malignant ovarian tumors (412.5 ± 210.8 U/mL) compared to benign ovarian tumors (46.3 ± 18.7 U/mL), endometriosis (78.9 ± 35.4 U/mL), PID (62.7 ± 28.9 U/mL), and controls (18.6 ± 6.2 U/mL). Elevated CA-125 levels were present in all malignant cases, while moderate elevations were also observed in endometriosis and PID. Postmenopausal women showed comparatively higher CA-125 levels than premenopausal women. Conclusion: CA-125 is a useful biomarker for identifying ovarian malignancy, particularly at markedly elevated levels. Nevertheless, benign gynecological disorders may also increase CA-125, limiting its specificity. Therefore, CA-125 should be interpreted alongside clinical findings and imaging for accurate diagnosis.