Abstract
Giriş: Serum CA-125 200,000 Da ağırlığında bir glikoproteindir. Endometriozis dahil birçok beningn ve malign jinekolojik hastalıkta yükselebilmektedir. CA-125 antijeni endometrium, endoserviks ve periton gibi normal dokularda da sentezlenmektedir. Endometriozis ise üreme çağındaki kadınların %5-15�ni etkileyen jinekolojik bir rahatsızlıktır. Tanıda tek güvenilir yöntem laparoskopi (L/S) beraberinde biyopsi yapılmasıdır. CA-125 ve CA-19-9 gibi bazı biyolojik belirleyiciler de tanıda yardımcı olarak kullanılabilmektedir. Olgu Sunumu: 21 yaşındaki bekar hasta dismonere ve pelvik ağrı şikayetiyle kliniğimize başvurdu. Endometriozis ön tanısıyla pelvik ultrasonografi (USG) yapılan hastada sağ overde 7 cm, sol overde 3 cm tipik görünümlü endometrioma kistleri saptandı ve hastanın CA-125 değeri 3200 U/ml idi. Bu bulgularla yapılan L/S ile tanı doğrulanarak kistektomi+ endometriozis odaklarının koagulasyonu ve eksizyonu yapıldı. 5 ay sonra hasta benzer şikayetlerle tekrar başvurdu. Yapılan USG�e sağ overde 35 mm boyutunda endometrioma kisti olduğu görüldü ve tekrar edilen CA-125 değeri 1325 U/ml olarak belirlendi. Hastaya tekrar L/S ile kistektomi+endometriozis odaklarının koagulasyonu ve eksizyonu uygulandı. Sonuç: Yüksek CA-125 değerleri olan hastalarda ileri evre endometriozis beklenmelidir. Bu hastalarda erken dönem rekürrens riski göz önüne alındığına sürekli hormonal baskılama düşünülebilir. Bu sayede hastaların asemptomatik dönemi uzatılarak hastanın hayat kalitesine katkıda bulunabilir. Takipler sırasında yükselen CA-125 değeri rekürrens açısından anlamlı kabul edilebilir.
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Abstract
Introduction: Serum CA-125, a 200,000 Da glycoprotein, concentration has been associated with the presence of many gynecologic disorders (Table 2), including endometriosis. The CA-125 antigen is expressed in many normal tissues such as the endometrium, endocervix and peritoneum. Increased CA-125 levels associated both with benign and malignant pathologies. In some women, CA-125 levels increase during menstruation, possibly because the menstrual endometrium refluxes into the peritoneal cavity. Case Report: 21 years old unmarried women with dysmenorrhea and pelvic pelvic pain admitted to our hospital. Past medical history was insignificant of any disease except asthma for which she was using inhaled beta-agonists and had regular menstrual cycles. With a presumptive diagnosis of endometriosis a pelvic ultrasound was performed, which revealed chocolate cysts one measuring 7cm in the right ovary and the other 3cm in the left ovary. The CA-125 level was 3200 U/ml. For evaluation of the cysts diagnostic L/S was performed. During the same procedure cystectomy+xcision and coagulation of endometriosis implants were performed and the final pathologic diagnosis was endometrioma which was originating from both ovaries. After a period of 5 months, patient re-admitted with pelvic pain and recurrence of chocolate cyst. This time the cyst size was 35mm and recurred in the right ovary. Repeated CA-125 value was 1325 U/ml and L/S cystectomy+excision and coagulation of endometriosis implants were performed. Conclusion: Endometriosis, one of the most commonly encountered gynecologic diseases, affects approximately 5 to 15% of women of childbearing age. Presently, the only reliable method for diagnosis is the visualization under general anesthesia of typical and atypical lesions during laparoscopic evaluation of the pelvic organs and peritoneum and biopsy. Tumor markers such as CA-125 and CA-19-9 could be used as an aid to the detection and diagnosis of endometriosis. Despite the controversy regarding the use of serum CA-125 for the diagnosis of endometriosis, it remains the only extensively studied nonsurgical test that has been considered in the past as a candidate marker for the detection of endometriosis. With extremely high CA-125 levels advanced stage endometriosis should be anticipated. Is these subset of patients symptom free interval may be short and continuous oral contraceptive use might be an option to increase the quality of life.
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Details
| Other ID | JA25JD49MB |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | July 1, 2005 |
| Submission Date | July 1, 2005 |
| Published in Issue | Year 2005 Volume: 8 Issue: 3 |