The Significance of Serum CA-125 in patients with Polycystic Ovarian Syndrome and its Association with their Hormonal Status

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting women of reproductive age. Due to the diagnostic uncertainty of some cases and the unclear pathophysiology of the syndrome, this study aimed to assess the significance of Cancer Antigen 125(CA-125) in the diagnosis and prediction of hormonal disorders of PCOS patients. Method and Results: A total of 100 women (70 PCOS patients and 30 healthy females) were enrolled in our case-control prospective study. Both groups were of similar age (mean age 23.97 vs 24.40 years, P=0.2), while body mass index (BMI) was significantly elevated in the PCOS group compared to controls (25.72 vs 20.95kg/m2, P=0.0001). Hirsutism was estimated using the modified Ferriman-Gallwey (mFG) scoring system. A significantly elevated hirsutism score was recorded in the PCOS group compared to controls (11.72 vs 4.50, P=0.0001). Biochemical tests including CA-125 and pituitary/gonadal hormones [luteinizing hormone (LH), follicle-stimulating hormone (FSH) and total testosterone] were all measured on serum samples. A statistically significant increase in LH levels (9.26 vs 3.89mIU/ml, P=0.0001), LH/FSH ratio (1.88 vs 0.67, P=0.0001) and total testosterone levels (88.93 vs 33.15ng/dl, P=0.0001) was observed in PCOS compared to controls. No significant difference was found in the FSH levels between the two groups (P=0.06). Interestingly, the CA-125 level was significantly higher in PCOS patients than in controls (17.90 vs 7.78 U/L, P=0,0001). CA-125 was positively correlated with LH and LH/FSH ratio, and negatively with FSH. The receiver operation characteristic curve was performed to determine a diagnostic cut-off value of CA-125 for PCOS. A CA-125 value of 11.45 U/L showed high diagnostic sensitivity and specificity (96.7% and 87.1%, respectively) for PCOS. Conclusion: Data from this study suggest that CA-125 could be used as an additional diagnostic biomarker for PCOS.