Serum Tumor Markers for Preoperative Discrimination of Benign and Malignant Adnexal Masses
Background: We aimed to determine the diagnostic values of individual tumor marker or combined in preoperative discrimination between benign and malignant ovarian tumors.
Methods: Medical data of 322 patients operated because of adnexal masses during 2009 - 2014 in Istanbul Research and Traning Hospital (a tertiary center) were retrospectively analyzed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (ACC) were determined for each individual tumor marker or markers combined.
Results: Median age of patients was 43 years. Of all patients, 68.3% were premenopausal and 31.7% were postmenopausal. CA125 levels in 29.8% patients, CA19-9 in 16.3% and CA15-3 in 6.1% were found higher than the cutoff value. The postmenopausal group had significantly higher levels of CA 125 and CA15-3 (P = 0.021 and P = 0.002, respectively) compared with the premenopausal group. In malignant cases, CA125 and CA15-3 were significantly higher (P < 0.001). Sensitivity, specificity, PPV, NPV and ACC of CA125 were 70.5%, 76.6%, 32.3%, 94.2% and 75.8%, respectively. Sensitivity, specificity, PPV, NPV and ACC of CA15-3 were 34.1%, 98.2%, 73.7%, 90.8% and 89.8%, respectively. There was no significant difference in CA19-9 levels between the benign and malignant groups. The ACC of combined CA125 + CA15-3 was 90.7%.
Conclusion: The elevated levels of CA125 or CA15-3 individually have a high diagnostic value for preoperative discrimination of benign/malignant adnexal masses. Combination of CA125 and CA15-3 does not present addtive effect. CA19-9 is not an appropriate marker for discrimination of benign/malignant adnexal masses.
Cell Mol Med Res. 2017;1(1):11-14