UICC World Cancer Congress 2006

Objective:The accuracy of diagnostic tests used to evaluate an adnexal mass is of great concern to practicing gynecologists. In the pre-operative assessment of adnexal mass, the major diagnostic tools are still clinical impression and ultrasound examination. The treatment of an ovarian cyst relies on its nature, and accurate preoperative discrimination of benign and malignant cysts is therefore of crucial importance. The objective of this study was to determine the ability of tumor marker assessment, gray-scale transvaginal with color Doppler ultrasonography to predict the nature of ovarian tumors.

Methods:Fifty patients with ovarian tumors requiring operative intervention entered the study prospectively underwent pelvic examination, tumor marker assessment and gray-scale transvaginal 6.5MHz transducer and extended transabdominally when needed with 3.5 MHz transducer, with color flow Doppler ultrasonography preoperatively. Risk of malignancy index, Sassone scoring were calculated respectively. Histopathology was taken as gold standard to compare the preoperative diagnosis.

Results:Out of 50 patients presented with ovarian tumors, 20 (40%) had malignant disease and 30 (60%) benign pathology. CA 125 tumor marker had sensitivity of 78% and specificity of 75%, risk of malignancy index had sensitivity of 86.67 %, specificity of 92.5 %. Ultrasound (Sassone scoring) had highest specificity of 93% and Doppler had highest sensitivity of 100%. All the above indices should be used together for appropriate diagnosis and management of ovarian neoplasm.