Diagnostic performance of CA125, ultrasound score and risk malignancy index in determining adnexal masses

Abstract

Context: Pre-operative assessment of adnexal masses aids in appropriate referral and in planning the optimal surgery. CA 125, Ultrasound Score and Risk of Malignancy Index are methods that can be used to triage such masses. Objective: The aim of this study was to evaluate the ability to of CA125, Ultrasound Score and Risk Malignancy Index to differentiate a benign from a malignant pelvic mass. Study Design: This IS a retrospective study of 97 women admitted to the Department of Obstetrics and Gynaecology at Mater Dei Hospital, between September 2015 and February 2016 for surgical investigation of pelvic masses. To diagnose ovarian cancer, the sensitivity, specificity, and positive predictive value of serum CA125, ultrasound score and menopausal status were taken separately and combined into four risk malignancy indices, RMI 1 - 4. Results: This study confirms that, for the diagnosis of malignancy, all four malignancy risk indices were more accurate than menopausal status, serum CA 125 levels, and ultrasound findings separately. We found that there is no statistically significant difference in the performance of the four different RMIs in discriminating malignancy. Conclusion: We concluded that all of the four malignancy risk indices described can be utilised for selection of cases for optimal treatment. These methods are simple techniques that can be used even in less-specialized gynaecology clinics to facilitate the triaging of cases for referral to an oncology unit.

Keywords: Adnexal mass, Ovarian cancer, Ultrasonography, CA125, Risk Malignancy Index