Objective: The aim of this study is to measure the serum levels of CA 125, ESR and CRP in patients with tubo-ovarian abscess (TOA) before and after treatment of abscess and to assess the usefulness of CA 125 in the diagnosis, prediction of the outcome of TOA treatment and clinical follow-up of patient’s condition. Methods: This retrospective study included 65 patients with TOA. Serum CA 125, ESR, CRP and WBC counts were measured. The treatment was done conservatively with antibiotics. The patients were divided into two groups: those with successful results into group 1 (29 cases) and those with unsuccessful results into group 2 (36 cases). If treatment was considered to be unsuccessful, surgical intervention was additionally performed. Results: The serum levels of CA 125, ESR and abscess size on admission in group 2 were significantly higher than in group 1. ESR, abscess size and CA 125 in order were valuable predictive factors affecting the success of medical treatment. And the new cutoff value was 36.5 mm/h, 4.2 cm and 68.3 U/ml, respectively. The sensitivity rate of CA 125, ESR levels was significantly higher in group 2 than in group 1. Although CRP was decreased significantly 10 days after treatment, the serum CA 125 was not decreased significantly. And it took 51.5 days for CA 125 to be normalized after the initiation of treatment. Conclusions: The serum CA125, ESR levels and abscess sizes are predictive factors affecting the success of medical treatment of abscess treatment. And CA 125 and ESR are useful for diagnosing severity of disease. But serum CA 125 level is an inappropriate marker for monitoring short-term efficacy of treatment.

Objective: The aim of this study is to measure the serum levels of CA 125, ESR and CRP in patients with tubo-ovarian abscess (TOA) before and after treatment of abscess and to assess the usefulness of CA 125 in the diagnosis, prediction of the outcome of TOA treatment and clinical follow-up of patient’s condition. Methods: This retrospective study included 65 patients with TOA. Serum CA 125, ESR, CRP and WBC counts were measured. The treatment was done conservatively with antibiotics. The patients were divided into two groups: those with successful results into group 1 (29 cases) and those with unsuccessful results into group 2 (36 cases). If treatment was considered to be unsuccessful, surgical intervention was additionally performed. Results: The serum levels of CA 125, ESR and abscess size on admission in group 2 were significantly higher than in group 1. ESR, abscess size and CA 125 in order were valuable predictive factors affecting the success of medical treatment. And the new cutoff value was 36.5 mm/h, 4.2 cm and 68.3 U/ml, respectively. The sensitivity rate of CA 125, ESR levels was significantly higher in group 2 than in group 1. Although CRP was decreased significantly 10 days after treatment, the serum CA 125 was not decreased significantly. And it took 51.5 days for CA 125 to be normalized after the initiation of treatment. Conclusions: The serum CA125, ESR levels and abscess sizes are predictive factors affecting the success of medical treatment of abscess treatment. And CA 125 and ESR are useful for diagnosing severity of disease. But serum CA 125 level is an inappropriate marker for monitoring short-term efficacy of treatment.

목적: 난소난관농양 환자의 혈청 CA 125를 포함한 ESR, CRP 수치 및 초음파 소견과 그 외 영향을 미치는 인자들을 조사, 분석하여 난소난관농양의 진단 및 수술적 중재 여부를 예측하고 추적검사를 할 수 있는 지표로서의 유용성을 알아보고자 하였다. 방법: 난소난관농양으로 입원한 총 65예의 난소난관농양 환자 중 보존적 치료에 성공한 29예를 보존적 치료군으로 설정하였고, 보존적 치료에 실패하여 침습적인 치료를 추가한 36예를 수술적 치료군으로 설정하였다. 연구 대상자들의 의무기록을 검토하여 후향적 연구를 시행하였다. 결과: 입원 시 측정한 혈청 CA 125를 비롯한 ESR, 농양의 크기는 난소난관농양의 치료에서 수술적 중재 여부 예측에 의미 있는 인자로 나타났다. 난소난관농양의 수술적 중재를 결정짓는 진단적 가치가 높은 인자는 ESR, 농양의 크기, CA 125순이며 이들의 새로운 양성 기준은 각각 36.5 mm/h, 4.2 cm, 68.3 U/ml이었다. CA 125 및 ESR의 민감도는 중증으로 진행된 병변에서 유의하게 증가하여 중증의 진행된 병변에서 진단적 가치가 있었다. 임상 경과의 추적 지표로서 CRP는 10일 내에 치료 경과 판정을 위한 추적검사로서 의의가 있으나 CA 125가 정상화되기까지 소요된 시간은 평균 51.5일로 CA 125는 단기간의 추적검사로서 부적절하다고 나타났다. 결론: 난소난관농양에서 CA 125, ESR 및 농양의 크기는 수술적 중재를 결정짓는 예측 인자이고 CA 125 및 ESR은 중증의 진행된 병변에서 진단적 가치가 있으나 CA 125는 임상 경과에 대한 단기간의 추적 지표로서 부적절함을 알 수 있다. 이를 바탕으로 난소난관농양의 진단 및 치료 기준안을 만들고 이에 따라 치료와 추적 검사를 시행한다면 치료 실패율을 현저히 낮추고 합병증과 재발을 줄이게 될 것이다.

난소난관농양, CA 125, 적혈구 침강계수, C-반응성 단백질