Expression of CA-125 Level And Neutrophil to Lymphocyte Ratio In Infected And Non-infected Endometrioma


Implantation and growth of endometriosis was determined by immune cell. There were several immunologic cells that promoting implantation and cell proliferation such as macrophages, Natural killer, lymphocyte and monocyte. Infected endometrioma was associated in women with revised American Society for Reproductive Medicine (ASRM) stage III-IV. Neutrophil lymphocyte ratio (NLR) was a simple systemic inflammation response markers. The sensitivity and spesificity CA-125 in predicting endometrioma was very low but it had been used to monitor the progress of endometriosis. Therefore, measuring mean in leucocyte, NLR, PLR and CA-125 level in infected endometrioma was necessary. 

[1] Y. Osuga, Current concepts of the pathogenesis of endometriosis, Reproductive Medicine and Biology, 9, no. 1, 1–7, (2010).

[2] S. Soural, N. Tempest, and DK. Hapangama, Theories on The Pathogenesis of Endometriosis, p. p

[3] L. Speroff and MA. Fritz, Endometriosis in Clinical Gynecology Endocrinology and Infertility. Lippincott William Wilkins, P, 8th edition.

[4] M. Králícková, V. Vetvicka, and M. Králíčková, Immunological Aspects of Endometriosis: a Review. Ann Transl Med, 153, 3(11, 2015.

[5] N. G. Osborne, Tubo-ovarian abscess: Pathogenesis and management, Journal of the National Medical Association, 78, no. 10, 937–951, (1986).

[6] M.-J. Chen, J.-H. Yang, Y.-S. Yang, and H.-N. Ho, Increased occurrence of tuboovarian abscesses in women with stage III and IV endometriosis, Fertility and Sterility, 82, no. 2, 498–499, (2004).

[7] S. K. Kavoussi, M. D. Pearlman, W. M. Burke, and D. I. Lebovic, Endometrioma complicated by tubo-ovarian abscess in a woman with bacterial vaginosis, Infectious Diseases in Obstetrics and Gynecology, 2006, Article ID 84140, (2006).

[8] C. P. C. de Jager, P. T. L. van Wijk, R. B. Mathoera, J. de Jongh-Leuvenink, T. van der Poll, and P. C. Wever, Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit, Critical Care, 14, no. 5, article no. R192, (2010).

[9] S. Cho, H. Cho, A. Nam, H. Y. Kim, Y. S. Choi, K. H. Park, D. J. Cho, and B. S. Lee, Neutrophil-to-lymphocyte ratio as an adjunct to CA-125 for the diagnosis of endometriosis, Fertility and Sterility, 90, no. 6, 2073–2079, (2008).

[10] A. Yavuzcan, M. Çalar, Y. Üstün, S. Dilbaz, I. Özdemir, E. Yildiz, A. Özkara, and S. Kumru, Evaluation of mean platelet volume, neutrophil/ lymphocyte ratio and platelet/lymphocyte ratio in advanced stage endometriosis with endometrioma, Journal of the Turkish German Gynecology Association, 14, no. 4, 210–215, (2013).

[11] H. Yang, L. Zhu, S. Wang, J. Lang, and T. Xu, Noninvasive Diagnosis of Moderate to Severe Endometriosis: The Platelet-Lymphocyte Ratio Cannot Be a Neoadjuvant Biomarker for Serum Cancer Antigen 125, Journal of Minimally Invasive Gynecology, 22, no. 3, 373–377, (2015).

[12] E. Ozhan, A. Kokcu, K. Yanik, and M. Gunaydin, Investigation of diagnostic potentials OF nine different biomarkers in endometriosis, European Journal of Obstetrics Gynecology and Reproductive Biology, 178, 128–133, (2014).

[13] K. Chmaj-Wierzchowska, M. Kampioni, M. Wilczak, S. Sajdak, and T. Opala, Novel markers in the diagnostics of endometriomas: Urocortin, ghrelin, and leptin or leukocytes, fibrinogen, and CA-125? Taiwanese Journal of Obstetrics and Gynecology, 54, no. 2, 126–130, (2015).

[14] J.-Y. Kwak, S.-W. Park, K.-H. Kim, Y.-J. Na, and K.-S. Lee, Modulation of neutrophil apoptosis by plasma and peritoneal fluid from patients with advanced endometriosis, Human Reproduction, 17, no. 3, 595–600, (2002).

[15] E. Somigliana, P. Viganò, A. S. Tirelli, I. Felicetta, E. Torresani, M. Vignali, and A. M. Di Blasio, Use of the concomitant serum dosage of CA 125, CA 19-9 and interleukin6 to detect the presence of endometriosis. Results from a series of reproductive age women undergoing laparoscopic surgery for benign gynaecological conditions,
Human Reproduction, 19, no. 8, 1871–1876, (2004).

[16] C. M. da Silva, A. Vilaça Belo, S. Passos Andrade, P. Peixoto Campos, M. Cristina França Ferreira, A. Lopes da Silva-Filho, and M. Mendonça Carneiro, Identification of local angiogenic and inflammatory markers in the menstrual blood of women with endometriosis, Biomedicine and Pharmacotherapy, 68, no. 7, 899–904, (2014).

[17] E. Berkes, F. Oehmke, H.-R. Tinneberg, K. T. Preissner, and M. Saffarzadeh, Association of neutrophil extracellular traps with endometriosis-related chronic inflammation, European Journal of Obstetrics Gynecology and Reproductive Biology, 183, 193–200, (2014).

[18] Ł. Milewski, P. Dziunycz, E. Barcz, D. Radomski, P. I. Roszkowski, G. KorczakKowalska, P. Kamiński, and J. Malejczyk, Increased levels of human neutrophil peptides 1, 2, and 3 in peritoneal fluid of patients with endometriosis: Association with neutrophils, T cells and IL-8, Journal of Reproductive Immunology, 91, no. 1-2,
64–70, (2011).

[19] I. Velasco, F. Quereda, R. Bermejo, A. Campos, and P. Acién, Intraperitoneal recombinant interleukin-2 activates leukocytes in rat endometriosis, Journal of Reproductive Immunology, 74, no. 1-2, 124–132, (2007).

[20] A. Laux-Biehlmann, T. D’hooghe, and T. M. Zollner, Menstruation pulls the trigger for inflammation and pain in endometriosis, Trends in Pharmacological Sciences, 36, no. 5, article no. 1219, 270–276, (2015).

[21] J. Sikora, A. Mielczarek-Palacz, Z. Kondera-Anasz, and J. Strzelczyk, Peripheral blood proinflammatory response in women during menstrual cycle and endometriosis, Cytokine, 76, no. 2, 117–122, (2015).