Laparoscopic Management of Peritonitis Due to a Ruptured Ovarian Endometrioma with Extremely High Levels of Cancer Antigen–125 and Cancer Antigen–19-9

Diagnostic Clues for Women with Acute Surgical Abdomen Associated with Ruptured Endometrioma

(1) Background: An investigation of the preoperative diagnostic clues used to identify ruptured endometrioma by comparing the ruptured and unruptured states in patients who underwent laparoscopic operations due to endometrioma. (2) Methods: Patients with ruptured endometriomas (14 patients) and unruptured endometriomas (60 patients) were included, and clinical symptoms, laboratory findings, and radiological findings were analyzed. (3) Results: There were no significant differences in age, parity, last menstrual cycle days, or median size of endometrioma between two groups (group A: ruptured; group B: unruptured). The median serum level of CA 125 was 345.1 U/mL in group A and 49.8 U/mL in group B (p = 0.000). The median serum levels of CA 19-9 in group A and B were 46.0 U/mL and 19.1 U/mL, respectively (p = 0.005). The median serum level of CRP in group A was 1.2 g/dL, whereas it was 0.3 in group B (p = 0.000). ROC analysis showed that the optimal CA 125 cutoff value was 100.9 U/mL; the optimal CA 19-9 cutoff value was 27.7 U/mL; and the optimal CRP cutoff value was 1.0 g/dL. (4) Conclusions: Ruptured endometrioma can be diagnosed preoperatively using a combination of clinical symptoms, laboratory findings, and radiological findings. If a physician suspects a ruptured endometrioma, surgery should be performed to ensure optimal prognosis.

Bio-nanocomposite based highly sensitive and label-free electrochemical immunosensor for endometriosis diagnostics application

In this research, for the first time, a bio-nanocomposites based highly sensitive and label-free electrochemical immunosensor is reported with the aim of endometriosis diagnostics application. Multiwalled carbon nanotube and magnetite nanoparticle (MWCNT-Fe₃O₄) was dispersed in chitosan (CS) to fabricate a bio-nanocomposite to immobilize very monoclonal specific antibody (via cross-linking using glutaraldehyde) for selective electrochemical immuno-sensing of carbohydrate antigen 19-9 (CA19-9), a potential biomarker for endometriosis diagnostics. Well-characterized Anti-Abs_CA19-9/CS-MWCNT-Fe₃O₄ immune-electrode fabricated on glassy carbon electrode (GCE) successfully detect CA 19-9 and exhibited a high sensitivity as (2.55 µA pg^-1 cm^-1), a detection limit of 0.163 pg mL^-1, detection range from 1.0 pg mL^-1 to 100 ng mL^-1. Our fabricated electrochemical Abs_CA19-9/CS-MWCNT-Fe₃O₄ immunosensor performed CA19-9 sensing in physiological range and at a very level which suggest it application for early-stage diagnostics, diseases monitoring, and optimization of therapy. To claim the clinical application, our sensor was tested using real samples and sensing performance was validated using enzyme-linked immune-sorbent assay (ELISA). The results of the studies projected Abs_CA19-9/CS-MWCNT-Fe₃O₄ electrochemical CA19-9 immunosensor as a potential and affordable alternate of conventional techniques like ELISA. We believe that our fabricated sensor can be the plane of a disease's management program due to affordable, rapid, label-free, and sensitive detection of a targeted biomarker.