对子宫腺肌病患者血清CA125及EMAb的临床评价

目的：探讨血清CA125及子宫内膜抗体（EMAb)测定，对子宫腺肌病的诊断及疗效评估的临床价值。方法：经术后病理学检查确诊子宫腺肌病患者63例和子宫肌瘤患者45例，均于术前及术后测定两组血清CA125水平和EMAb。结果：子宫腺肌病组术前血清CA125平均水平及EMAb阳性率均高于子宫肌瘤组，两者相比差异有显著性（P＜0．001及P＜0．01）。联合测定血清CA125水平和EMAb，以两者均阳性为诊断标准，诊断子宫腺肌病的敏感性为54．63％，特异性为100％。子宫腺肌病组术后血清CA125水平和EMAb阳性率均较术前下降，差异有显著性（P＜0．01及P＜0．05）。结论：测定血清CA125及EMAb对子宫腺肌病有较好的辅助诊断价值，联合检测更能提高诊断的正确性，并可作为评价子宫腺肌病疗效的敏感指标。     

曼月乐治疗子宫腺肌病合并卵巢巧克力囊肿的临床观察

目的:探讨左炔诺孕酮宫内缓释系统(LNG-IUS,商品名:曼月乐)治疗子宫腺肌病合并卵巢巧克力囊肿的临床效果。方法观察11例子宫腺肌病合并卵巢巧克力囊肿的患者,放置LNG-IUS后月经情况、痛经程度、子宫内膜及体积、卵巢囊肿体积、CA125行自身前后对照。结果在放置LNG-IUS后,痛经显著缓解,6个月内子宫内膜明显变薄,子宫体积及卵巢囊肿体积在置环后没有明显的增大。结论LNG-IUS使疾病保持静止,是治疗子宫腺肌病合并卵巢巧克力囊肿的一种较为有效且安全的方法。     

血清CA125与抗子宫内膜抗体联合测定对子宫内膜异位症的诊断价值

目的 探讨血清CA125与抗子宫内膜抗体联合测定对于宫内膜异位症诊断的临床价值。方法 应用放射免疫法及酶联免疫吸附试验（ELISA）法测定44例子宫内膜异位症患者（EMT组）血清中CA125值及EMAb阳性情况，并与40例健康妇女对照组进行比较。结果 EMT组血清CA125值阳性率为61．4％（27／44），显著高于对照组5．0％（2／40），P〈0．05；EMT组抗子宫内膜抗体阳性率为65．9％（29／44），显著高于对照组7．5％（3／40），P〈0．05；联合测定EMT患者血清CA125值及抗子宫内膜抗体，其敏感性明显高于两者单独测定的敏感性。结论 血清CA125与抗子宫内膜抗体联合测定可提高子宫内膜异位症诊断的敏感性。     

子宫与卵巢异位内膜细胞凋亡和增殖特性的研究

目的　探讨子宫腺肌病与卵巢异位囊肿异位内膜的细胞凋亡和增殖特性及发病机制。方法　 2 0 0 2年 6月至 2 0 0 3年 6月南方医科大学珠江医院采用免疫组化S P法 ,检测子宫腺肌病 (46例 )和卵巢异位囊肿 (6 0例 )的在位及异位子宫内膜中凋亡调控基因蛋白bcl 2、bax及细胞增殖标记物Ki 6 7蛋白的表达。结果　bcl 2蛋白、bax蛋白及Ki 6 7蛋白在两症的在位内膜以及子宫腺肌病异位内膜中均呈现周期性改变 ,而bcl 2蛋白及Ki 6 7蛋白在卵巢异位囊肿异位内膜中呈持续性增强 ,较在位内膜差异有显著性意义 (P <0 0 5 )。结论　子宫腺肌病异位内膜的细胞凋亡和增殖受卵巢性激素周期性的调节 ,卵巢异位囊肿异位内膜则相反 ,两者细胞凋亡和增殖特性有着明显的不同 ,是两种不同的疾病。     

子宫腺肌病与子宫肌瘤的临床比较

目的 探讨子宫腺肌病与子宫肌瘤的临床特点及B超、实验室检测的价值，提高对子宫腺肌病术前的诊断率。方法 选择5年来我院妇产科子宫切除术后经病理证实的子宫腺肌病患者120例为子宫腺肌病组，随机选择同期子宫切除术后经病理证实的子宫肌瘤患者120例为子宫肌瘤组，对两组患者年龄分布、既往史、临床症状、术前诊断、B超检查、血清CA125水平进行比较。结果 两种疾病均好发于生育年龄妇女，常有月经过多或经期延长，经分析差异无显著性（P〉0．05）。子宫腺肌病术前诊断率56．1％，出现痛经、性交痛较多，但继发性贫血少；具有特征性的超声表现；血清CA125水平明显升高。结论 子宫腺肌病诊断的金标准是病理诊断，但其既往史、特有症状、B超改变、血清CA125水平增高仍是诊断该病的重要参考指标，并可与子宫肌瘤进行手术前鉴别。     

子宫腺肌病/卵巢异位囊肿炎性压力及其与临床特征相关性研究

目的：系统探讨子宫腺肌病/卵巢异位囊肿患者外周血炎性指标变化及其与临床特征的相关性,为子宫腺肌病/卵巢异位囊肿抗炎治疗提供依据。方法：选取来自同济大学附属杨浦医院收治的子宫腺肌病手术患者58例（子宫腺肌病组）、卵巢异位囊肿手术患者37例（卵巢异位囊肿组）,健康女性47例（对照组）,于增生期抽取外周血,检测血清炎性细胞因子和肿瘤相关抗原浓度,分析炎性压力与临床特征的相关性。结果：子宫腺肌病组外周血中性粒细胞（Neu）、Neu%、中性粒细胞与淋巴细胞比值（NLR）、白细胞介素6（IL-6）、IL-8、CA199、CA125高于对照组,差异有统计学意义（均P＜0.05）;子宫腺肌病组外周血血红蛋白（HGB）低于对照组,差异有统计学意义（Z=688.50,P=0.00）。卵巢异位囊肿组外周血Neu、Neu%、NLR、IL-6、IL-8、肿瘤坏死因子-α（TNF-α）、CA199和CA125高于对照组,差异有统计学意义（均P＜0.05）。子宫腺肌病中度痛经组外周血白细胞（WBC）、CA125高于轻度痛经组,差异有统计学意义（均P＜0.05）。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-8和IL-6高于中度痛经组,差异有统计学意义（均P＜0.05）。子宫腺肌病重度痛经组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于轻度痛经组,差异有统计学意义（均P＜0.05）。子宫腺肌病中、重度痛经组外周血HGB低于轻度痛经组,差异有统计学意义（均P＜0.05）。子宫腺肌病经量过多组外周血WBC、Neu、Neu%、NLR、IL-6、IL-8和CA125高于正常月经组,差异有统计学意义（均P＜0.05）。卵巢异位囊肿重度痛经组外周血IL-6、IL-8高于轻度、中度痛经组,差异有统计学意义（均P＜0.05）。子宫内膜异位症患者肿瘤指标与外周血炎性指标在统计学上无明显相关性。结论：子宫腺肌病/卵巢异位囊肿处于全身炎症压力状态,并与临床特征相关,为子宫内膜异位症抗炎治疗提供了依据。。     

超声检查及血清CA125测定诊断子宫腺肌病的评价

目的探讨超声检查及血清癌抗原125(CA125)测定对子宫腺肌病的诊断价值.方法通过对120例疑为子宫腺肌病或子宫肌瘤患者,行术前腹部B超和血清CA125测定;术后切下组织送病理学检查确诊并与之对照.结果经术后病理学证实子宫腺肌病组术前血清CA125检测敏感度73.8%, 特异度73.5%; B超诊断该病的敏感度55.4%, 特异度64.8%; 以两种方法联合检测均阳性为诊断标准, 则敏感度52.5%, 特异度94.1%.结论测定血清CA125水平,对子宫腺肌病是较好的辅助诊断指标;B超检查对该病有一定诊断价值;两者联合检测能提高诊断的正确性,且方法简便、快捷、无创伤,是目前较为实用的诊断方法.     

血清及腹腔液CA125测定对子宫腺肌病的诊断价值

目的探讨血清及腹腔液CA125测定对子宫腺肌病的诊断价值.方法采用免疫化学发光法测定28例子宫腺肌病和25例子宫肌瘤患者血清及腹腔液(110稀释)CA125水平.结果子宫腺肌病患者血清CA125水平高于子宫肌瘤患者,差异有显著性(P＜0.01).两组间腹腔液CA125水平差异无显著性(P=0.18).腹腔液CA125水平明显高于血清CA125水平(P＜0.01),但二者无明显相关性(P＞0.50).腺肌病患者血清CA125水平受子宫大小、大体病理类型、使用性激素等因素影响.结论如用于子宫腺肌病的辅助诊断,血清CA125测定较腹腔液CA125测定敏感.腹腔液中CA125的主要来源可能为腹膜上皮细胞.     

T-钙黏蛋白、血管内皮钙黏蛋白与子宫腺肌病及子宫内膜异位症关系的研究

目的探讨T-钙黏蛋白（T-cad）、血管内皮钙黏蛋白（VE-cad）与子宫腺肌病（AM）及子宫内膜异位症（EM）的关系。方法采用免疫组化SP二步法检测子宫腺肌病（腺肌病组,45例）、卵巢子宫内膜异位囊肿（异位囊肿组,45例）、子宫腺肌病合并卵巢子宫内膜异位囊肿（合并组,45例）及正常子宫内膜（对照组,45例）T-cad与VE-cad表达,并行两者的相关性分析。结果①腺肌病组、异位囊肿组和合并组在位内膜T-cad的表达率分别是11.11%（5/45）、4.44%（2/45）和11.11%（5/45）,与对照组（37.78%,17/45）比较,差异有统计学意义（P〈0.05）;②腺肌病组、异位囊肿组、合并组腺肌病异位内膜、合并组卵巢异位内膜VE-cad的表达率分别为71.11%（32/45）、64.44%（29/45）、42.22%（19/45）和33.33%（15/45）,4组比较,差异有统计学意义（P〈0.05）;③异位囊肿组Ⅰ~Ⅱ期T-cad的表达率（71.43%,10/14）高于Ⅲ~Ⅳ期（3.23%,1/31;P〈0.05）,而合并组Ⅰ~Ⅱ期T-cad的表达率（25.00%,3/12）高于Ⅲ~Ⅳ期（0,0/33;P〈0.05）;④T-cad与VE-cad在各组子宫内膜的表达无相关性（｜r｜〈0.3,P〉0.05）。结论 T-钙黏蛋白在AM及EM内膜上表达低于正常内膜,而血管内皮钙黏蛋白在AM及EM内膜上表达较正常内膜升高,可能与及发病相关。     

盆腔良性肿物伴血清CA125水平升高的临床意义

目的探讨血清CA125水平在妇科良性肿瘤、结核性肿物及其他炎症性肿物、子宫内膜异位症等盆腔良性肿物中的升高情况及临床意义.方法回顾性分析中国医学科学院中国协和医科大学肿瘤医院于1999年1月-2003年12月间收治并经病理检查证实的492例妇科盆腔良性肿物患者的临床资料,其中卵巢良性肿瘤237例,其他盆腔良性肿物如子宫肌瘤、子宫腺肌病、卵巢子宫内膜异位症、盆腔结核及其他炎症性肿物等共255例,所有患者术前均有血清CA125的检测.另随机选取60例卵巢上皮性癌患者作为对照.结果盆腔结核、子宫腺肌病、卵巢子宫内膜异位症及卵泡膜-纤维组肿瘤患者的血清CA125水平中位数值均高于正常值(35 kU/L以下),分别是465.0、88.9、59.0、44.5 kU/L.本组盆腔良性肿物中, 血清CA125水平单例最高值为卵泡膜-纤维组肿瘤(1281.0 kU/L),中位数值最高者为盆腔结核(465.0 kU/L).60例卵巢上皮性癌患者血清CA125水平升高者达95.0%,其中位数值是755.5 kU/L,与良性肿物相比,差异有统计学意义(P<0.01 ).在子宫肌瘤与子宫腺肌病的鉴别诊断中,以血清CA125≥50 kU/L为标准,诊断子宫腺肌病的敏感性、特异性、阳性预测值及阴性预测值相对较高,分别是72%、94%、79%和91%.结论血清CA125水平升高也可见于一些盆腔良性肿物,主要有盆腔结核、子宫腺肌病、卵巢子宫内膜异位症及卵泡膜-纤维组肿瘤等,但其中位数值均明显低于卵巢上皮性癌.血清CA125水平检测有利于子宫肌瘤和子宫腺肌病的鉴别诊断.     

Usefulness of measurement of serum CA125 levels in diagnosing and treating endometriosis

We investigated the usefulness of the measurement of serum CA125 levels for the diagnosis and therapeutic monitoring of endometriosis. An additional study concentrated on the production of CA125. 1. Elevated levels of serum CA125 were noted in 52 of 66 patients with endometriosis in which the positive rate was 78.8% and mean was 119.8 U/ml. The mean value and positive rate of serum CA125 levels in patients with adenomyosis were higher than those in pelvic endometriosis. 2. The correlation between preoperative serum CA125 levels and the extracted tissue weight was statistically significant. The tissue concentration of CA125 of adenomyosis was 1,479.3 +/- 1,087.1 U/g and that of pelvic endometriosis was 309.7 +/- 23.1 U/g wet weight. 3. The serum CA125 levels in patients with adenomyosis fell postoperatively, and all were below 35 U/ml within two weeks. The serum CA125 levels were below 35 U/ml in 13 out of 15 patients (86.7%) with pelvic endometriosis treated with danazol and the change in the serum CA125 levels was closely related to the clinical course. 4. Clinicopathological states with a high level of serum CA125 were observed in patients with normal and ectopic pregnancy, puerperium, ovarian hyperstimulation syndrome (OHSS) and peritonitis. It was concluded that the measurement of serum CA125 levels was useful in the diagnosis and therapeutic monitoring of endometriosis, and CA125 might be produced and/or secreted not only from the endometrium but also from the peritoneum.     

不同部位子宫内膜异位症与血清CA125水平的关系

目的:探讨血清CA125水平与不同部位的子宫内膜异位症之间的相关性。方法:选择经手术或腹腔镜确诊的内异症患者63例和排除内异症的对照组30例,按内异症发生部位的不同分为3组:Ⅰ组(卵巢内异组)34例;Ⅱ组(阴道直肠隔内异组)15例;Ⅲ组(腹壁切口内异组)14例。Ⅳ组为对照组,系临床和病理检查排除了内异症的健康者。术前采取空腹静脉血,用化学发光法测定各组血清中CA125水平。结果:(1)卵巢内异组、阴道直肠内异组的血清CA125水平均显著高于对照组(P<0·05);腹壁切口内异组CA125水平显著低于卵巢内异组(P<0·05),而与阴道直肠隔内异症组、对照组比较无统计学差异(P>0·05);(2)以血清CA125≥35U/ml为临界值,CA125诊断各组内异症的敏感性分别为:卵巢内异症52·94%,阴道直肠内异症40·00%,腹壁切口内异症21·43%。诊断特异性为96·67%。结论:CA125在诊断子宫内膜异位症发生方面具有一定的价值,但并不是敏感指标。单凭血清CA125不能鉴别不同部位的子宫内异症。     

A critical evaluation of transvaginal Doppler studies, transvaginal sonography, magnetic resonance imaging, and CA 125 in detecting ovarian cancer.

OBJECTIVE: To evaluate whether transvaginal Doppler ultrasound is more valid than transvaginal sonography, magnetic resonance imaging (MRI), and CA 125 in differentiating malignant from benign ovarian tumors. METHODS: Sixty-three patients with ovarian tumors (36 benign and 27 malignant) were studied with transvaginal Doppler ultrasound before surgery. Blood flow velocity waveforms arising from intratumoral and/or tumor surface arteries were assessed by calculating the resistance index. Transvaginal B-mode sonography and MRI imaging examinations were also conducted. Serum CA 125 levels were measured. RESULTS: There was a significant difference between the resistance index value (0.692 +/- 0.188) in benign tumors and the value (0.503 +/- 0.107) in malignant tumors (P < .05). When 0.72 (mean of the malignant tumor resistance index values + 2 standard deviations) was considered as the cutoff value of the resistance index, the sensitivity and specificity of the resistance index in detecting malignant ovarian tumors were 92.6 and 52.8%, respectively. These values did not differ significantly from those with transvaginal sonography diagnosis (sensitivity 85.2%, specificity 69.4%). The resistance index sensitivity was significantly higher than those with MRI diagnosis (66.7%) and CA 125 levels (59.3%) (P < .05); however, the resistance index specificity was significantly lower than those with MRI diagnosis (97.1%) and CA 125 levels (91.7%) (P < .05). CONCLUSION: Our results suggest that transvaginal Doppler ultrasound does not provide more useful diagnostic information than transvaginal sonography, MRI, and CA 125 for the differentiation of malignant from benign ovarian tumors.     

Differential diagnosis of ovarian cancer, benign ovarian tumor and endometriosis by a combination assay of serum sialyl SSEA-1 antigen and CA125 levels

We used a combination assay of serum sialyl SSEA-1 antigen (SLX) and CA125 levels, and evaluated the clinical usefulness of this technique for a differential diagnosis of ovarian cancer, benign ovarian tumor and endometriosis. In 82 patients with ovarian tumors, the sera of 20 (64.5%) of 31 with ovarian cancer and 15 (48.4%) of the 31 with endometriosis (endometrial cyst) were positive for both SLX and CA125, but serum SLX level was 5 U/ml or less in these 14 SLX- and CA125-positive patients with endometriosis. The sera of 16 (80.0%) patients with benign ovarian tumor were negative for both tumor markers. The sera of 3 (9.7%) of 31 with ovarian cancer and the sera of 2 (6.5%) of 31 with endometriosis were negative for both markers. The diagnostic accuracy (true positive rate X true negative rate) of the combination assay for ovarian cancer was 49.0% when the cutoff value of the serum SLX was 38 U/ml but improved to 78.5% when the value was set at 50 U/ml. When the cutoff value of serum SLX was set at 50 U/ml and that of serum CA125 at 35 U/ml, 27 of 37 patients who were positive only for CA125 had endometriosis. From the above observations, a combination assay of serum SLX and CA125 is a promising method for the differential diagnosis of malignant and benign ovarian tumors. Our results also suggest that to improve the diagnostic accuracy, the cutoff value of the serum SLX level should be 50 U/ml for ovarian tumors alone.     

人附睾分泌蛋白4联合CA125在卵巢恶性肿瘤与子宫内膜异位症鉴别诊断中的价值

目的 探讨血清人附睾分泌蛋白4(HE4)联合CA125水平检测在卵巢恶性肿瘤与子宫内膜异位症鉴别诊断中的价值.方法 采用酶联免疫吸附试验(ELISA)检测卵巢子宫内膜异位囊肿(内异症组)46例、卵巢上皮性癌(卵巢癌组)36例、卵巢非内膜异位良性肿瘤(良性肿瘤组)60例和健康妇女(对照组)50例血清中HE4和CA125水平,结果以中位数表示.血清HFA和CA125正常值分别为0～150 pmo/L和0～35 kU/L,单独或联合检测时,其中任一指标高于正常上限即定为阳性.通过制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)反映诊断的准确性;以Mann-Whitney U 检验及相关性分析探讨两项指标单独或联合检测用于诊断卵巢内异症囊肿的价值.结果 (1)HE4水平:内异症、对照、良性肿瘤组妇女血清HE4水平分别为52.4、51.0、50.0 pmoL/L,3组比较,差异无统计学意义(P>0.05),卵巢癌组患者HE4水平为507.5 pmoL/L,与其他3组分别比较,差异均有统计学意义(P<0.05).(2)CA125水平:卵巢癌、内异症、良性肿瘤及对照组妇女血清CA125水平分别为743.0、84.9、15.4、11.5 kU/L,卵巢癌组与其他3组比较,差异均有统计学意义(P<0.05).(3)单项榆测结果:卵巢癌组以内异症组为参照时,HE4和CA125笛单项检测的AUC分别0.933和0.821,其特异度为95%时的敏感度分别为79.6%和49.0%;内异症组以对照组为参照时的AUC为0.453;以良性肿瘤组为参照时的AUC为0.496.(4)联合检测结果:卵巢癌组以内异症组为参照时,HE4联合CA125检测的AUC为0.936,其特异度为95%时的敏感度为81.0%.结论 HE4水平可作为卵巢内异症囊肿的鉴别诊断依据之一,HE4联合CA125水平检测能有效鉴别卵巢内异症囊肿和卵巢恶性肿瘤.     

彩色多普勒阴道超声对诊断恶性畸胎瘤的价值

目的探讨彩色多普勒阴道超声及血清甲胎蛋白（AFP）测定对诊断恶性畸胎瘤的价值。方法对2000年～2005年我院收治畸胎瘤患者465例，其中未成熟畸胎瘤13例，成熟畸胎瘤恶变3例，进行回顾性分析，着重探讨彩色多普勒阴道超声下肿物声像图特征及血流情况。部分患者进行了血清AFP测定。结果彩色多普勒阴道超声术前诊断恶性畸胎瘤及恶性卵巢肿瘤10例（10／16），符合率62．5％。未成熟畸胎瘤组9例进行了AFP测定，阳性6／9例（66．7％）；在成熟畸胎瘤恶变3例患者中，AFP均为阴性。结论彩色多普勒超声对恶性畸胎瘤诊断符合率较高，结合血清AFP含量测定，有助于对未成熟畸胎瘤，畸胎瘤恶变及卵黄囊瘤的鉴别。     

The mechanism of the increase in the serum CA125 concentration in patients with endometriosis

We discussed the mechanism of the increase in CA125 among patients with benign gynecologic diseases, especially with endometriosis. The tissue CA125 concentrations of surface endometrium in patients with adenomyosis were as follows; the highest tissue concentration was observed at the early proliferative phase followed by the late secretory one and was lowest in the late proliferative one. The tissue CA125 concentration showed the significantly different characteristics in surface and ectopic endometrium. The increase in CA125 in the intraperitoneal fluids was observed among cases of early pregnancy, acute appendicitis and ovarian hyperstimulation syndrome (OHSS). Tissue samples from both the peritoneum obtained from patients with acute appendicitis and the cyst wall obtained from OHSS cases showed a high concentration of tissue CA125. From these findings, it was suggested that one of the causes of serum CA125 increase in patients with adenomyosis appeared to be the increase in the ectopic endometrial tissues in the myometrium and direct shedding from ectopic endometrial cells into peripheral circulation. On the other hand, in patients with chocolate cysts, the increase in serum CA125 was suppressed because it was secreted into the inside of the chocolate cyst. The production of CA125 may take place not only from ectopic endometrial cells of adenomyosis but also from the peritoneal tissues of patients with acute appendicitis.     

Follow up of women with simple ovarian cysts detected by transvaginal sonography in the Tokyo metropolitan area

Objective To investigate the management of women with asymptomatic ovarian masses, to determine the appropriate duration of follow up, and to identify diagnostic indicators of growing cysts.
Design Review of women's hospital records.
Setting Tokyo Metropolitan Cancer Detection Center, Japan.
Population Two hundred and twenty-five pre- and postmenopausal women with a diagnosis of ovarian cyst ≥6 cm in diameter and normal serum level of CA125, diagnosed between 1 October 1990 and 25 December 1991.
Main outcome measure Change in size of cyst as shown by ultrasound.
Results Seventy-five months after initial diagnosis, 29 (13%) of the masses had progressed, 31 (14%) had persisted, and 165 (73%) had regressed. One hundred and nine masses (48%) had regressed within six months of the initial diagnosis. In univariate analysis transvaginal ultrasonographic assessment of morphology findings, cyst diameter, carcinoembyronic antigen (CEA) and CA 19.9 were associated with the prognosis of the cyst. Multivariate regression analysis demonstrated that only the initial serum CA19-9 level and serum CEA level were significant predictors of ovarian masses that regressed (P for trend = 0.004 and 0.02, respectively).
Conclusion Simple ovarian cysts in patients with a normal level of CA125 have a low risk for ovarian cancer. Vaginal ultrasound at six months will identify regression of most simple cysts. CA19-9 and CEA at the initial diagnosis are useful parameters to predict future regression of ovarian cysts.     

Follow up of women with simple ovarian cysts detected by transvaginal sonography in the Tokyo metropolitan area.

OBJECTIVE: To investigate the management of women with asymptomatic ovarian masses, to determine the appropriate duration of follow up, and to identify diagnostic indicators of growing cysts. DESIGN: Review of women's hospital records. SETTING: Tokyo Metropolitan Cancer Detection Center, Japan. POPULATION: Two hundred and twenty-five pre- and postmenopausal women with a diagnosis of ovarian cyst < 6 cm in diameter and normal serum level of CA125, diagnosed between 1 October 1990 and 25 December 1991. MAIN OUTCOME MEASURE: Change in size of cyst as shown by ultrasound. RESULTS: Seventy-five months after initial diagnosis, 29 (13%) of the masses had progressed, 31 (14%) had persisted, and 165 (73%) had regressed. One hundred and nine masses (48%) had regressed within six months of the initial diagnosis. In univariate analysis transvaginal ultrasonographic assessment of morphology findings, cyst diameter, carcinoembyronic antigen (CEA) and CA19-9 were associated with the prognosis of the cyst. Multivariate regression analysis demonstrated that only the initial serum CA19-9 level and serum CEA level were significant predictors of ovarian masses that regressed (P for trend = 0.004 and 0.02, respectively). CONCLUSION: Simple ovarian cysts in patients with a normal level of CA125 have a low risk for ovarian cancer. Vaginal ultrasound at six months will identify regression of most simple cysts. CA19-9 and CEA at the initial diagnosis are useful parameters to predict future regression of ovarian cysts.