OC23.02: Which histologies limit the ability of CA-125 to characterize adnexal masses? An observational study of 3511 patients

2010 ◽  
Vol 36 (S1) ◽  
pp. 42-42
Author(s):  
B. Van Calster ◽  
C. Van Holsbeke ◽  
J. Zhang ◽  
D. Jurkovic ◽  
A. A. Lissoni ◽  
...  
2016 ◽  
Author(s):  
Nidhi Bansal ◽  
A. Suneja ◽  
K. Guleria ◽  
N. B. Vaid ◽  
K. Mishra ◽  
...  

Introduction: HE4 is a novel tumour biomarker used for early diagnosis of ovarian cancer. This study evaluated the diagnostic accuracy of HE4 alone and in combination with CA125, risk of malignancy index (RMI), risk of malignancy algorithm (ROMA). Methods: It was a cross sectional study conducted recruiting 88 women with adnexal masses who were planned for surgery. After baseline work up and ultrasound examination, serum samples were collected for estimation of CA 125 and HE4 levels. Serum HE4 levels were estimated using ELISA kit. RMI and ROMA score were calculated and diagnostic accuracy of HE4, CA 125, RMI, ROMA and their combination were compared. Cut off for HE4 and ROMA score were calculated using ROC curve. Results: Of 88 subjects, 66 were analyzed with 19 malignant (including 5 LMP) and 47 benign cases. The median value of HE4 among malignant cases was found to be significantly higher than among the benign cases. PPV and NPV of HE4 at a cut off 130.8 pMol/ml was 85.7% and 77.9% respectively. Highest PPV (88.9%) with acceptable NPV (80.7%) was found with ROMA followed by HE4 (PPV 85.7%; NPV 77.97%), RMI (PPV 76.92%; NPV 83%) and CA125 (PPV 52%; NPV 80.85%). Conclusion: HE4 levels were lower in Indian population both in malignant and benign tumours as compared to other studies. HE4 is a good discriminator and gives best accuracy when it is combined with CA125 in a logistic algorithm, ROMA.


2012 ◽  
Vol 59 (3) ◽  
pp. 49-56
Author(s):  
Ivana Likic-Ladjevic ◽  
Milan Terzic ◽  
Nebojsa Ladjevic ◽  
Jelena Dotlic ◽  
Igor Pilic ◽  
...  

OBJECTIVE: The aim of the study was to examine several tumor markers and their correlation with pathohistological findings in patients with adnexal masses. METHODS: Study involved 139 patients, 84 of them with benign, 47 with malignant and 8 with borderline adnexal tumor. Levels of CA 125, CA 19-9, CEA and CA 15-3 were obtained preoperatively and assessed regarding the specific pathohistological diagnose and the patient?s age. Obtaining these results led us to divide the patient?s CA 125 levels with age and by doing that we have attained a new Tumor Marker Age score (TMA score). Results: Patients with malignant adnexal tumors had significantly higher levels of CEA (p<0.05), CA 125, CA 19-9 and CA 15-3 tumor markers (p<0.01), in comparison with patients with benign tumors. TMA score highly statistically correlate with the tumor type (benignant/malignant). CONCLUSIONS: With the increase of tumor marker levels and the patient?s age the malignant nature of adnexal tumors is more often. Results of our study highlight the importance of the use of combined tumor markers (at least CA-125 and CA 19-9) in women with adnexal masses. Those levels along with the patient?s age and new TMA score could preoperatively predict malignant nature of the tumor.


2020 ◽  
Vol 22 (4) ◽  
pp. 199-202
Author(s):  
Manisha Acharya ◽  
P Kumar ◽  
BB Shrestha ◽  
S Shrestha ◽  
R Amatya ◽  
...  

Adnexal mass is a common clinical finding in gynaecological practice. The study aims to find out the diagnostic value of clinical examination, ultrasonography and Ca-125 and its correlation, using Risk of Malignancy Index with histopathological diagnosis in adnexal masses. Clinical records were retrieved of women who had surgical management for adnexal mass in the last 2 years duration. Based on the data, Risk of Malignancy Index values were calculated. It was then compared with histopathological diagnosis. Out of 66 patients, 56 patients had benign tumor and 10 patients had malignancy. The Risk of Malignancy Index values of each patient was calculated which ranged from 8 to 2205 with mean value of 425.52 (SD±41.8). Risk of Malignancy Index sensitivity was 70%, specificity was 96.42%, positive predictive value was 77.78%, and negative predictive value was 95.83%. Risk of Malignancy Index is a reliable diagnostic tool in differentiating benign from malignant adnexal masses.


2011 ◽  
Vol 21 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Evelien Vaes ◽  
Ranjit Manchanda ◽  
Rina Nir ◽  
Dror Nir ◽  
Harry Bleiberg ◽  
...  

Purpose:Accurate preoperative clinical assessment of adnexal masses can optimize outcomes by ensuring appropriate and timely surgery. This article addresses whether a new technology, ovarian HistoScanning, has an additional diagnostic value in mathematical models developed for the differential diagnosis of adnexal masses.Patients and Methods:Transvaginal sonography-based morphological variables were obtained through blinded analysis of archived images in 199 women enrolled in a prospective study to assess the performance of ovarian HistoScanning. Logistic regression (LR) and neural network (NN) models including these variables and clinical and patient data along with the HistoScanning score (HSS) (range, 0-125; based on mathematical algorithms) were developed in a learning set (60% patients). The remaining 40% patients (evaluation set) were used to assess model performance.Results:Of all morphological and clinical variables tested, serum CA-125, presence of a solid component, and HSS were most significant and used to develop the LR model. The NN model included all variables. The novel variable, HSS, offered significant improvement in the LR and NN models' performance. The LR and NN models in an independent evaluation set were found to have area under the receiver operating characteristic curve = 0.97 (95% confidence interval [CI], 94-99) and 0.93 (95% CI, 88-98), sensitivities = 83% (95% CI, 71%-91%) and 80% (95% CI, 67%-89%), and specificities = 98% (95% CI, 89%-99%) and 86% (95% CI, 72%-95%), respectively. In addition, these models showed an improved performance when compared with 3 other existing models (allP< 0.05).Conclusions:This initial report shows a clear benefit of including ovarian HistoScanning into mathematical models used for discriminating benign from malignant ovarian masses. These models may be specifically helpful to the less experienced examiner. Future research should assess performance of these models in prospective clinical trials in different populations.


2007 ◽  
Vol 30 (4) ◽  
pp. 415-415
Author(s):  
L. Valentin ◽  
D. Jurkovic ◽  
B. Van Calster ◽  
A. Testa ◽  
C. Van Holsbeke ◽  
...  

2021 ◽  
Author(s):  
Arturas Dobilas ◽  
Charlotte Thålin ◽  
Håkan Wallén ◽  
Christer Borgfeldt

Abstract Background Inflammation is a hallmark of cancer, and emerging light is being shed on the neutrophil release of nuclear chromatin, referred to as neutrophil extracellular traps (NETs) in cancer and cancer associated thrombosis. The NET-specific marker citrullinated histone H3 (H3Cit) has been found to be elevated in plasma from patients with malignancies, suggesting the potential of NET markers, such as H3Cit, as novel cancer biomarkers. Objective To determine the levels of plasma H3Cit in blood in women with adnexal masses. Subjects and Method s: Peripheral blood samples were obtained preoperatively from 199 patients admitted for primary surgery of adnexal masses 2015–2017. Patients were grouped according to tumor type and stage of cancer. Plasma levels of H3Cit-DNA, cell free DNA (cfDNA) and the clinically implemented tumor marker cancer antigen 125 (CA125) were determined with ELISA. Results Plasma levels of H3Cit-DNA and cfDNA were not elevated in women with borderline or malignant ovarian tumors compared with women with benign tumors. Increased plasma levels of CA125 were detected in borderline and ovarian cancer stage I and stage II-IV compared with benign ovarian tumor patients (ptrend<0.001). In Cox regression analysis high levels of Ca 125 dichotomized at 326 IU/ml (median) showed worse overall survival hazard ratio 1.9 (95 % C.I. 1.03–3.36; p = 0.038). No differences were found in the survival analyses in malignant ovarian tumors analyzing the cfDNA and H3Cit-DNA levels. Conclusion This study did not find any association nor prognostic association between the plasma levels of the NET marker H3Cit and ovarian cancer patients.


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