P21.01: CA-125 versus power Doppler as second step technique for predicting ovarian cancer in a large cohort of women with adnexal masses

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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Comparison of 2-dimensional and 3-dimensional power-Doppler imaging in complex adnexal masses for the prediction of ovarian cancer

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2004.10.630 ◽

2005 ◽

Vol 192 (3) ◽

pp. 807-812 ◽

Cited By ~ 42

Author(s):

Juan Luis Alcázar ◽

Gerardo Castillo

Keyword(s):

Ovarian Cancer ◽

Power Doppler ◽

Doppler Imaging ◽

Adnexal Masses ◽

3 Dimensional ◽

Power Doppler Imaging

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Early-Stage Ovarian Malignancy Score versus Risk of Malignancy Indices: Accuracy and Clinical Utility for Preoperative Diagnosis of Women with Adnexal Masses

Medicina ◽

10.3390/medicina56120702 ◽

2020 ◽

Vol 56 (12) ◽

pp. 702

Author(s):

Phichayut Phinyo ◽

Jayanton Patumanond ◽

Panprapha Saenrungmuaeng ◽

Watcharin Chirdchim ◽

Tanyong Pipanmekaporn ◽

...

Keyword(s):

Ovarian Cancer ◽

Clinical Utility ◽

Early Stage ◽

Ca 125 ◽

Lower Sensitivity ◽

Ovarian Malignancy ◽

Threshold Probability ◽

Adnexal Masses ◽

Risk Of Malignancy ◽

Early Stage Ovarian Cancer

Background and objectives: To compare the diagnostic accuracy and clinical utility of the Early-stage Ovarian Malignancy (EOM) score with the Risk of Malignancy Index (RMI) in the presurgical assessment of women presenting with adnexal masses. Materials and Methods: A secondary analysis was carried out in a retrospective cohort of women who presented with an adnexal mass and were scheduled for surgery at Phrapokklao Hospital between September 2013 and December 2017. The clinical characteristics, ultrasonographic features of the masses, and preoperative CA-125 levels were recorded. The EOM and the RMI score were calculated and compared in terms of accuracy and clinical utility. Decision curve analysis (DCA), which examined the net benefit (NB) of applying the EOM and the RMI in practice at a range of threshold probabilities, was presented. Results: In this study, data from 270 patients were analyzed. Fifty-four (20.0%) women in the sample had early-stage ovarian cancer. All four RMI versions demonstrated a lower sensitivity for the detection of patients with early-stage ovarian cancer compared to an EOM score ≥ 15. An EOM ≥ 15 resulted in a higher proportion of net true positive or NB than all versions of the RMIs from a threshold probability of 5% to 30%. Conclusions: It also showed a higher capability to reduce the number of inappropriate referrals than the RMIs at a threshold probability between 5% and 30%. The EOM score showed higher diagnostic sensitivity and has the potential to be clinically more useful than the RMIs to triage women who present with adnexal masses for referral to oncologic gynecologists. Further external validation is required to support our findings.

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Peri and post-menopausal women with complex adnexal masses, ascites, and raised CA-125: Is it ovarian cancer or tuberculosis?

Journal of Mid-life Health ◽

10.4103/0976-7800.195700 ◽

2016 ◽

Vol 7 (4) ◽

pp. 193

Author(s):

Tanuja Muthyala ◽

Rashmi Bagga ◽

SubhasChandra Saha ◽

Shalini Gainder ◽

PradipKumar Saha ◽

...

Keyword(s):

Ovarian Cancer ◽

Ca 125 ◽

Adnexal Masses ◽

Menopausal Women ◽

Post Menopausal

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Comparative study between serum level of hepatocyte growth factor and CA-125 in patients with suspicious malignant adnexal masses

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164631 ◽

2016 ◽

Vol 6 (1) ◽

pp. 38

Author(s):

Ziad Mansour Ahmed ◽

Helmy Helmy Abdel Satar ◽

Moyassar Ahmed Zaki ◽

Hassan Mansour Hassan

Keyword(s):

Ovarian Cancer ◽

Growth Factor ◽

Serum Level ◽

Hepatocyte Growth Factor ◽

Serum Levels ◽

Ca 125 ◽

Control Group ◽

Ovarian Carcinomas ◽

Adnexal Masses ◽

Hepatocyte Growth

Background: Hepatocyte growth factor has been described to be increased in different cancers. The aim of the present study is to evaluate as a screening marker the‏ serum level of Hepatocyte growth factor among suspicious adnexal masses as compared to serum levels of CA125.Methods: The present study included 80 female patients who are admitted to the Gynecology unit in Elshatby Maternity University Hospital divided into two groups. Forty patients with benign gynecological conditions (control group) and 40 patients with suspicious malignant adnexal masses (cases group). Preoperative blood samples were withdrawn from all patients of both cases and control group to assess the level of serum hepatocyte growth factor (HGF) and serum cancer antigen 125 (CA 125). Both were quantified using ELISA technique.Results: Out of the 40 cases with suspicious malignant adnexal masses, 35 had ovarian cancer while five only were borderline. Patients with ovarian carcinomas had significantly higher preoperative HGF and CA 125 serum levels than patients with borderline pathology. Patients with borderline tumors had a significantly higher serum HGF and CA 125 levels than patients with benign gynecological conditions in control group.Conclusions: HGF in serum was elevated in 71% of patients with suspicious malignant adnexal masses proved to be ovarian cancer by histopathology using a quantitative ELISA. HGF can be used as a screening tool for ovarian cancer.

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Three-dimensional ultrasound and three-dimensional power Doppler in the assessment of adnexal masses

The Ultrasound Review of Obstetrics & Gynecology ◽

10.3109/14722240108500425 ◽

2001 ◽

Vol 1 (2) ◽

pp. 167-183

Author(s):

A. Kurjak ◽

V. Sparac ◽

S. Kupesic ◽

I. Bekavac

Keyword(s):

Power Doppler ◽

Three Dimensional ◽

Adnexal Masses

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A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

Asian Journal of Medical Sciences ◽

10.3126/ajms.v11i5.29548 ◽

2020 ◽

Vol 11 (5) ◽

pp. 54-60

Author(s):

Apurba Mandal ◽

Shibram Chattopadhyay ◽

Sushanta Mondal ◽

Arunava Biswas

Keyword(s):

Ovarian Cancer ◽

Adnexal Mass ◽

Malignant Tumors ◽

Histopathological Examination ◽

Tertiary Care ◽

Ca 125 ◽

Tertiary Care Centre ◽

Gynecology And Obstetrics ◽

Risk Of Malignancy ◽

Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

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