Accurate pre-operative diagnosis of ovarian cancer by a combination of clinical criteria, ultrasonography and CA 125 - abstract

ABSTRACT

Early pre-operative treatment of ovarian cancer is hindered by a lack of reliable criteria for its early diagnosis. This study was undertaken to assess the value of clinical criteria, ultrasonography and serum CA 125 values in the differential diagnosis of benign and malignant pelvic masses. Thirty-six consecutive patients who had elective surgery for investigation and management of an adnexal mass were enrolled in the study from May to October, 1988. All patients had a clinical examination, serum CA 125 measurement and ultrasound pre-operatively, and their menopausal status determined. Based on these findings, a scoring system was devised (Table). Twenty patients had serum CA 125 values < 35 U/ml and histology confirmed a benign ovarian lesion. The remaining 16 patients had serum CA 125 levels > 35 U/ml, and their tumours were confirmed to be malignant histologically. There were significant differences in age (p<0.01), menopausal status (p=0.01), clinical impression score (p<0.01), ultrasound score (p<0.001) and serum CA 125 level (p<0.001) in patients with benign as compared to malignant lesions. The most useful single diagnostic criterion was serum CA 125 levels, and diagnostic accuracy was increased by adding menopausal status and ultrasound findings (sensitivity > 90 per cent; specificty 95.2 per cent) (AU)