Author/Editor		Antonič, J; Rakar, S
Title		Validity of colour and pulsed Doppler US and tumour marker CA 125 in differentiation between benign and malignant ovarian masses
Type		članek
Source		Eur J Gynaecol Oncol
Vol. and No.		Letnik 17, št. 1
Publication year		1996
Volume		str. 29-35
Language		eng
Abstract		BACKGROUND: Colour and pulsed Doppler flow imaging have been proposed as methods that may be useful in differentiating benign from malignant ovarian masses. It has been hypothesised that the detection of neovascularisation with abnormal, low-resistance blood flow peculiar to malignant tumours is possible, being characterised by angle-independent Doppler indices--PI and RI. The initial studies reported cut-off values of 1.0 for PI and 0.4 or 0.7 for RI, with values below the cut-off suggestive of malignancy. Tumour marker CA 125 SC was found to be elevated in 80-85 percent of patients with serous epithelial ovarian cancer (90 percent of all ovarian cancers) and in a lower percentage in other ovarian cancers, with levels over 35 U/ml suggestive of malignancy. In our study we wanted to determine whether colour and pulsed Doppler US and CA 125 SC could be used to differentiate benign from malignant ovarian masses and whether, by combining the methods, the results could even be improved. METHODS: Ovarian masses identified with sonography in 71 patients aged 35 years or more, were confirmed at surgery (n = 61) or endoscopy (n = 4) or followed up to resolution with US (n = 6). Colour and pulsed Doppler US were used to identify intratumoral areas of vascularisation and to calculate the lowest PI and RI for each ovarian mass. CA 125 SC were measured. RESULTS: In 16 of 18 ovarian malignancies and 28 of 53 benign masses, areas of intratumoral vascularisation (colour flow) were detected with colour Doppler US (p = 0.002). Mean RI was lower in malignant than in benign masses (p = 0.198), as was PI (p = 0.248). Index values displayed considerable overlap between malignant and benign lesions and the differences were not significant. Mean CA 125 SC was higher in malignant than in benign masses (p = less th. 0.0001). For cut-off at 35 U/ml, SE, SP, PPV and NPV for identification of ovarian cancer were 83 percent, 74 percent, 79 percent and 75 percent respectively.(trunc.)
Descriptors		CA-125 ANTIGEN OVARIAN DISEASES OVARIAN NEOPLASMS TUMOR MARKERS, BIOLOGICAL ADULT AGED AGED, 80 AND OVER DIAGNOSIS, DIFFERENTIAL MIDDLE AGE PROSPECTIVE STUDIES REPRODUCIBILITY OF RESULTS ULTRASONOGRAPHY, DOPPLER, COLOR ULTRASONOGRAPHY, DOPPLER, PULSED