Ultrasonographic criteria and tumor marker assay are good procedures for the diagnosis of ovarian neoplasia in preselected outpatients

Purpose of investigation: To identify parameters for the diagnosis of ovarian neoplasia using ultrasonography (US) and serum tumor marker (TM: CA125, CA19.9, CA15.3, AFP, CEA and estradiol) assay.

Methods: Prospective study which included 373 women with increased ovarian volume (> 18 cm3 in premenopause and > 8 cm3 in postmenopause). US criteria (> or = 1) for surgery were: persistent (> 4 months) or increased cyst, cysts with > 1 thick septum or > or = 2 thin septa, cyst diameter > or = 7 cm, vegetation, calcification or cystic predominance (> 50%), solid tumor (> 50%). Doppler with a resistance index (RI) < 0.4 was considered abnormal.

Results: Laparotomy was performed in 164 (44%) patients with 66 (40.2%) benign neoplasias and 19 (11.6%) malignant cases (73.6% at Stage I or II). Two hundred and nine patients were maintained on clinical follow-up. The sensitivity for neoplasia and malignant neoplasia was, respectively, for RI: 17 and 63.6 and RI plus TM: 53.1 and 90.9.

Conclusion: Ultrasound criteria and TM assay were indicated for the diagnosis of ovarian neoplasia.

Ovarian neoplasia; Ultrasonography; Tumor markers; Doppler

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