Diagnostic Value of Serum Cancer Antigen 125, Carcinoembryonic Antigen, Cancer Antigen 19-9, Anti Müllerian Hormone, White Blood Cell Count, Platelet Count, and Neutrophil to Lymphocyte Ratio in Endometriosis: A Retrospective Study

Background: Endometriosis is among the leading causes of morbidity in the female population worldwide. Currently, the definite diagnosis of endometriosis depends on laparoscopy as the gold-standard method. Potential biomarkers, such as inflammatory biomarkers, cancer antigens, and hormones, offer no...

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Main Authors: Behnaz Nouri, Niki Talebian, Ladan Kharaz, Mahdi Falah Tafti
Format: Article
Language:English
Published: Royan Institute (ACECR), Tehran 2025-07-01
Series:International Journal of Fertility and Sterility
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Online Access:https://www.ijfs.ir/article_718405_e2b9decf45df07ae59519e7550714b44.pdf
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author Behnaz Nouri
Niki Talebian
Ladan Kharaz
Mahdi Falah Tafti
author_facet Behnaz Nouri
Niki Talebian
Ladan Kharaz
Mahdi Falah Tafti
author_sort Behnaz Nouri
collection DOAJ
description Background: Endometriosis is among the leading causes of morbidity in the female population worldwide. Currently, the definite diagnosis of endometriosis depends on laparoscopy as the gold-standard method. Potential biomarkers, such as inflammatory biomarkers, cancer antigens, and hormones, offer non-invasive alternatives. This study was de­signed to investigate the utility of some hematological markers, including white blood cell (WBC) count, neutrophil to lymphocyte ratio (NLR), platelet count, cancer antigen 19-9 (CA 19-9), and 125 (CA-125), carcinoembryonic antigen (CEA), and anti Müllerian hormone (AMH), as non-invasive methods for endometriosis diagnosis.Materials and Methods: In this retrospective study, which was performed on 346 females, the case group consisted of 230 endometriosis patients. The data of 116 patients with benign tumors or other benign conditions such as Mülle­rian anomalies, were used as the control group. Receiver-operating characteristic (ROC) analysis was implemented to calculate specificities and sensitivities of CA-125, CA 19-9, CEA, NLR, WBC count, platelet (PLT) count, and AMH.Results: Significantly higher mean values were observed for CA-125, CA 19-9, WBC count, and NLR in the case group compared with the control group (P<0.001). The combination of NLR and CA-125 demonstrated the highest diagnostic performance with an area under the curve (AUC) of 0.903. However, the AUC for CA-125 (0.896) was lower and the value of 12.7 IU/mL was the most appropriate cut-off point (sensitivity=93.9%, specificity=60.9%). The cut-off value of 35 for CA-125 was also evaluated (sensitivity=61.4%, specificity=98.3%). The AUC for NLR was 0.699 and the best cut-off point was 1.5 (sensitivity=83.4%, specificity=52.6%).Conclusion: Combined measurement of CA-125 and NLR showed the highest performance in the diagnosis of endo­metriosis and can be considered as a diagnostic marker. However, it is necessary to conduct more research to evaluate the applicability of these biomarkers.
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spelling doaj-art-3d1dda4eef0447e2b8128501ae472aea2025-08-20T03:27:33ZengRoyan Institute (ACECR), TehranInternational Journal of Fertility and Sterility2008-076X2008-07782025-07-0119325926310.22074/ijfs.2024.2010957.1534718405Diagnostic Value of Serum Cancer Antigen 125, Carcinoembryonic Antigen, Cancer Antigen 19-9, Anti Müllerian Hormone, White Blood Cell Count, Platelet Count, and Neutrophil to Lymphocyte Ratio in Endometriosis: A Retrospective StudyBehnaz Nouri0Niki Talebian1Ladan Kharaz2Mahdi Falah Tafti3Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranPreventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranStudent Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranStudent Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranBackground: Endometriosis is among the leading causes of morbidity in the female population worldwide. Currently, the definite diagnosis of endometriosis depends on laparoscopy as the gold-standard method. Potential biomarkers, such as inflammatory biomarkers, cancer antigens, and hormones, offer non-invasive alternatives. This study was de­signed to investigate the utility of some hematological markers, including white blood cell (WBC) count, neutrophil to lymphocyte ratio (NLR), platelet count, cancer antigen 19-9 (CA 19-9), and 125 (CA-125), carcinoembryonic antigen (CEA), and anti Müllerian hormone (AMH), as non-invasive methods for endometriosis diagnosis.Materials and Methods: In this retrospective study, which was performed on 346 females, the case group consisted of 230 endometriosis patients. The data of 116 patients with benign tumors or other benign conditions such as Mülle­rian anomalies, were used as the control group. Receiver-operating characteristic (ROC) analysis was implemented to calculate specificities and sensitivities of CA-125, CA 19-9, CEA, NLR, WBC count, platelet (PLT) count, and AMH.Results: Significantly higher mean values were observed for CA-125, CA 19-9, WBC count, and NLR in the case group compared with the control group (P<0.001). The combination of NLR and CA-125 demonstrated the highest diagnostic performance with an area under the curve (AUC) of 0.903. However, the AUC for CA-125 (0.896) was lower and the value of 12.7 IU/mL was the most appropriate cut-off point (sensitivity=93.9%, specificity=60.9%). The cut-off value of 35 for CA-125 was also evaluated (sensitivity=61.4%, specificity=98.3%). The AUC for NLR was 0.699 and the best cut-off point was 1.5 (sensitivity=83.4%, specificity=52.6%).Conclusion: Combined measurement of CA-125 and NLR showed the highest performance in the diagnosis of endo­metriosis and can be considered as a diagnostic marker. However, it is necessary to conduct more research to evaluate the applicability of these biomarkers.https://www.ijfs.ir/article_718405_e2b9decf45df07ae59519e7550714b44.pdfbiomarkerca-125diagnosisendometriosis
spellingShingle Behnaz Nouri
Niki Talebian
Ladan Kharaz
Mahdi Falah Tafti
Diagnostic Value of Serum Cancer Antigen 125, Carcinoembryonic Antigen, Cancer Antigen 19-9, Anti Müllerian Hormone, White Blood Cell Count, Platelet Count, and Neutrophil to Lymphocyte Ratio in Endometriosis: A Retrospective Study
International Journal of Fertility and Sterility
biomarker
ca-125
diagnosis
endometriosis
title Diagnostic Value of Serum Cancer Antigen 125, Carcinoembryonic Antigen, Cancer Antigen 19-9, Anti Müllerian Hormone, White Blood Cell Count, Platelet Count, and Neutrophil to Lymphocyte Ratio in Endometriosis: A Retrospective Study
title_full Diagnostic Value of Serum Cancer Antigen 125, Carcinoembryonic Antigen, Cancer Antigen 19-9, Anti Müllerian Hormone, White Blood Cell Count, Platelet Count, and Neutrophil to Lymphocyte Ratio in Endometriosis: A Retrospective Study
title_fullStr Diagnostic Value of Serum Cancer Antigen 125, Carcinoembryonic Antigen, Cancer Antigen 19-9, Anti Müllerian Hormone, White Blood Cell Count, Platelet Count, and Neutrophil to Lymphocyte Ratio in Endometriosis: A Retrospective Study
title_full_unstemmed Diagnostic Value of Serum Cancer Antigen 125, Carcinoembryonic Antigen, Cancer Antigen 19-9, Anti Müllerian Hormone, White Blood Cell Count, Platelet Count, and Neutrophil to Lymphocyte Ratio in Endometriosis: A Retrospective Study
title_short Diagnostic Value of Serum Cancer Antigen 125, Carcinoembryonic Antigen, Cancer Antigen 19-9, Anti Müllerian Hormone, White Blood Cell Count, Platelet Count, and Neutrophil to Lymphocyte Ratio in Endometriosis: A Retrospective Study
title_sort diagnostic value of serum cancer antigen 125 carcinoembryonic antigen cancer antigen 19 9 anti mullerian hormone white blood cell count platelet count and neutrophil to lymphocyte ratio in endometriosis a retrospective study
topic biomarker
ca-125
diagnosis
endometriosis
url https://www.ijfs.ir/article_718405_e2b9decf45df07ae59519e7550714b44.pdf
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