Cell Mol Med Res

Cellular and Molecular Medicine Research, ISSN 2817-6359 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cell Mol Med Res and Elmer Press Inc

Journal website https://www.thecmmr.org

Original Article

Volume 1, Number 1, September 2023, pages 27-31

Serum Tumor Markers for Preoperative Discrimination of Benign and Malignant Adnexal Masses

**Table 1.** Features of Patients
SD: standard deviation; IQR: interquartile range.
Age (years), average ± SD/median/IQR	43.6 ± 14.2/43/34 - 52
Menopause, n (%)
Premenopausal	220 (68.3)
Postmenopausal	102 (31.7)
Preop CA125 (U/mL), average ± SD/median/IQR	116.8 ± 543.2/16.4/9.1 - 43.8
≤ 35, n (%)	226 (70.2)
> 35, n (%)	96 (29.8)
Preop CA19-9 (U/mL), average ± SD/median/IQR	35.9 ± 103.9/12.4/6.4 - 26
≤ 35, n (%)	268 (83.8)
> 35, n (%)	52 (16.3)
Preop CA15-3 (U/mL), average ± SD/median/IQR	22.9 ± 80.3/13.8/8.6 - 18.7
≤ 31, n (%)	294 (93.9)
> 31, n (%)	19 (6.1)
Tumor size (cm), average ± SD/median/IQR	6.7 ± 4.3/5.5/4 - 8
Tumor form, n (%)
Solid	16 (5.0)
Cystic	191 (59.3)
Mix	115 (35.7)
Tumor type, n (%)
Benign	278 (86.3)
Malignant	44 (13.7)

Table 1. Features of Patients

SD: standard deviation; IQR: interquartile range.

Age (years), average ± SD/median/IQR

43.6 ± 14.2/43/34 - 52

Menopause, n (%)

Premenopausal

220 (68.3)

Postmenopausal

102 (31.7)

Preop CA125 (U/mL), average ± SD/median/IQR

116.8 ± 543.2/16.4/9.1 - 43.8

≤ 35, n (%)

226 (70.2)

> 35, n (%)

96 (29.8)

Preop CA19-9 (U/mL), average ± SD/median/IQR

35.9 ± 103.9/12.4/6.4 - 26

≤ 35, n (%)

268 (83.8)

> 35, n (%)

52 (16.3)

Preop CA15-3 (U/mL), average ± SD/median/IQR

22.9 ± 80.3/13.8/8.6 - 18.7

≤ 31, n (%)

294 (93.9)

> 31, n (%)

19 (6.1)

Tumor size (cm), average ± SD/median/IQR

6.7 ± 4.3/5.5/4 - 8

Tumor form, n (%)

Solid

16 (5.0)

Cystic

191 (59.3)

Mix

115 (35.7)

Tumor type, n (%)

Benign

278 (86.3)

Malignant

44 (13.7)

**Table 2.** Histopathological Results
	n	%
Serous cystadenoma	70	21.7
Endometrioma	62	19.3
Mature cystic teratoma	45	14.0
Serous adenocarcinoma	19	5.9
Serous cystadenofibroma	19	5.9
Corpus luteal cyst	18	5.6
Mucinous cystadenoma	16	5.0
Paraovarian cyst	13	4.0
Fibrotecoma	10	3.1
Granulosa cell tumor	8	2.5
Clear cell carcinoma	7	2.2
Follicular cyst	7	2.2
Seromucinous cystadenom	5	1.6
Basic serous cyst	4	1.2
Fibroma	4	1.2
Carcinosarcoma	4	1.2
Mucinous adenocarsinoma	4	1.2
Tuboovarian abscess	3	0.9
Brenner tumor	1	0.3
Endometrioid type adenocarsinoma	1	0.3
Germ cell tumor	1	0.3
Cystadenofibroma	1	0.3

Table 2. Histopathological Results

Serous cystadenoma

21.7

Endometrioma

19.3

Mature cystic teratoma

14.0

Serous adenocarcinoma

5.9

Serous cystadenofibroma

5.9

Corpus luteal cyst

5.6

Mucinous cystadenoma

5.0

Paraovarian cyst

4.0

Fibrotecoma

3.1

Granulosa cell tumor

2.5

Clear cell carcinoma

2.2

Follicular cyst

2.2

Seromucinous cystadenom

1.6

Basic serous cyst

1.2

Fibroma

1.2

Carcinosarcoma

1.2

Mucinous adenocarsinoma

1.2

Tuboovarian abscess

0.9

Brenner tumor

0.3

Endometrioid type adenocarsinoma

0.3

Germ cell tumor

0.3

Cystadenofibroma

0.3

**Table 3.** Preoperative Tumor Marker Levels and Menopausal Situations
	Premenopause, average ± SD/min. -max./median	Postmenopause, average ± SD/min. -max./median	P
CA125, U/mL	6.2 ± 157.3/0.6 - 1632.8/19.3	249.5 ± 931.1/1.8 - 7,170/11.1	0.021
CA19-9, U/mL	37.0 ± 114.9/0 - 1,174.7/12.6	33.6 ± 75.4/0 - 580.7/11.3	0.737
CA15-3, U/mL	14.1 ± 13.4/0 - 173.3/12.6	41.6 ± 139.4/1.5 - 1,306/15.6	0.002
Pathology, n (%)
Benign	204 (92.7)	74 (72.6)	< 0.001
Malignant	16 (7.3)	28 (27.4)

Table 3. Preoperative Tumor Marker Levels and Menopausal Situations

Premenopause, average ± SD/min. -max./median

Postmenopause, average ± SD/min. -max./median

CA125, U/mL

6.2 ± 157.3/0.6 - 1632.8/19.3

249.5 ± 931.1/1.8 - 7,170/11.1

0.021

CA19-9, U/mL

37.0 ± 114.9/0 - 1,174.7/12.6

33.6 ± 75.4/0 - 580.7/11.3

0.737

CA15-3, U/mL

14.1 ± 13.4/0 - 173.3/12.6

41.6 ± 139.4/1.5 - 1,306/15.6

0.002

Pathology, n (%)

Benign

204 (92.7)

74 (72.6)

< 0.001

Malignant

16 (7.3)

28 (27.4)

**Table 4.** Preoperative Tumor Marker Levels
	Pathology	P
CA125, U/mL	36.4 ± 78.4/0.6 - 1,053/15	624.7 ± 1,362.8/3.3 - 7,170/59.8	< 0.001
CA19-9, U/mL	68.0 ± 146.4/0 - 705.9/14.5	68.0 ± 146.4/0 - 705.9/14.5	0.5
CA15-3, U/mL	14.6 ± 16.2/0 - 193.2/12.9	78.5 ± 211.9/3.3 - 1,306/21.2	< 0.001

Table 4. Preoperative Tumor Marker Levels

Pathology

Benign, average ± SD/min. -max./median

Malignant, average ± SD/min. -max./median

CA125, U/mL

36.4 ± 78.4/0.6 - 1,053/15

624.7 ± 1,362.8/3.3 - 7,170/59.8

< 0.001

CA19-9, U/mL

68.0 ± 146.4/0 - 705.9/14.5

0.5

CA15-3, U/mL

14.6 ± 16.2/0 - 193.2/12.9

78.5 ± 211.9/3.3 - 1,306/21.2

< 0.001

**Table 5.** Preoperative Tumor Marker Diagnostic Values
	Sensitivity	Specificity	PPV	NPV	ACC
CA125	70.5%	76.6%	32.3%	94.2%	75.80%
CA19-9	30.2%	85.90%	25.0%	88.8%	78.40%
CA15-3	34.1%	98.20%	73.7%	90.8%	89.80%
CA125 + CA15-3	34.1%	99.3%	87.5%	90.9	90.7%

Table 5. Preoperative Tumor Marker Diagnostic Values

Sensitivity

Specificity

PPV

NPV

ACC

CA125

70.5%

76.6%

32.3%

94.2%

75.80%

CA19-9

30.2%

85.90%

25.0%

88.8%

78.40%

CA15-3

34.1%

98.20%

73.7%

90.8%

89.80%

CA125 + CA15-3

34.1%

99.3%

87.5%

90.9

90.7%