Effect of hysterosalpingography on serum cancer antigen (CA-125) levels

Objective: The aim of our study was to detect any rise in serum levels of CA-125 after hysterosalpingography (HSG) as a result of irritation of the peritoneum.

Study design: Serum levels of CA-125 were assessed before HSG and at the 2nd and 6th hours after HSG in 32 infertile patients who were admitted to our clinic from April 2002 to September 2002. Patients who showed tubal occlusion or Asherman Syndrome were excluded from the study. The levels of serum CA-125 were compared statistically. Statistical analysis was performed with SPSS 10.0 statistical software and the paired-sample t-test was applied.

Results: The mean levels of serum CA-125 before HSG, and at the 2nd and 6th hours after HSG were; 14.11 +/- 5.97 mIU/ml, 13.96 +/- 5.80 mIU/ml, and 14.06 +/- 5.80 mIU/ml, respectively. There was no statistically significant difference between serum levels of CA-125 before HSG and at the 2nd or 6th hours after HSG, and also between the 2nd and 6th hours after HSG (p > 0.05).

Conclusion: We have not found any reports up to date about the levels of serum CA-125 after HSG. In our study we did not detect any increase in levels of serum CA-125 at the 2nd and 6th hours after HSG in spite of peritoneal irritation. We propose that this finding is because leakage of radioopaque material to the abdominal cavity is minimal during the HSG procedure.

CA-125; Hysterosalpingography; Peritoneal irritation

[1] Kawabe T., Ishii M., Sugimoto M., Tagawwa H.: "Low serum CA 125 concentration in chronic renal failure treated with continuous ambulatory perytoneal dialysis". Clin. Chim. Acta, 1987, 168, 113.

[2] Finkler NJ., Benecerrat B., Lavin P., Wojciechowski C., Knapp R.C.: "Comparison of serum CA 125, clinical impression and ultrasound in the preoperative evaluation of ovarian masses" Ohstet. Gynecol., 1988, 72, 659.

[3] Kato H., Hatori M., Watanabe M., Kokobun S.: "Epithelioid sarcomas with elevated serum CA-125: report of two cases". Jpn. J. Clin. Oncol., 2003, 33, 141.

[4] Bokhari A., Rosenfeld G.S., Cracchiolo B., Heller D.S.: "Cystic strurna ovarii presenting with ascites and an elevated CA-125 level. A case report". J. Reprod. Med., 1994, 39, 510.

[5] Niloff J.M., Knapp R.C., Schaetzl E., Reynolds C., Bast R.C.: "CA-125 serum levels in obstetrics and gynecology". Ohstet. Gynecol., 1984, 64, 703.

[6] Kashyap R.J.: "Extremely elevated serum CA-125 due to endornetriosis". Aust. New Zealand J. Ohstet. Gynaecol., 1999, 39, 269.

[7] Ismail M.A., Rotrnensch J., Mercer L.J., Block B.S., Salti G.I., Holt C.A.: "CA 125 in peritoneal fluid from patients with nonmalignant gynecologic disorders". J. Rep rod. Med., 1994, 39, 510.

[8] Gocrnen A., Karaca M., Tarakcioglu M.: "A ruptured ovarian endornetrioma mimicking ovarian malignancy". Eur. J. Gynaecol. Oncol., 2003, 4, 445.

[9] Sevinc A., Buyukberber S., Sari R., Kiroglu Y., Turk H.M., Ates M.: "Elevated serum CA-125 levels in hemodialysis patients with peritoneal, pleural, or pericardial fluids". Gynecol. Oncol., 2000, 77, 254.

[10] Turk H.M., Pekdemir H., Buyukberber S., Sevinc A., Camci C., Kocabas R. et al.: "Serum CA-125 levels in patients with chronic heart failure and accompanying pleural fluid". Tumour Biol., 2003, 24, 172.

[11] Bulsa M., Nowacki M., Perzanowski P.: "Elevated level of CA-125 anugen m women m reproductwe age WIthout ncoplasuc dIseases in pelvic minor". Ginecol. Pol., 2002, 73, 517.

[12] Bastani B., Chu N.: "Serum CA-125 level in end-stage renal disease patients maintened on chronic peritoneal dialysis or hernodialysis: T he effect of continuous presence of peritoneal fluid, peritonitis, and peritoneal catheter implantation". Am. J Nephrol., 1995, 15, 468.