title: Comparison of the usefulness of serum CA 125 level and a risk scoring system in detecting malignancy in ovarian cysts.
abstract: A prospective study was carried out to compare the sensitivity, specificity, positive and negative predictive values, and the accuracy of serum CA 125 measurement with a clinical risk scoring system in the detection of malignant ovarian cysts. One hundred and three patients admitted to one department of obstetrics and gynaecology within a 12-month period were studied. There were 22 cases of malignant ovarian cysts. The sensitivity, specificity, positive and negative predictive values, and accuracy were 81.8%, 72.0%, 43.9%, 93.7% and 75.0% respectively for a raised serum CA 125 measurement (> or = 35 u/ml) alone, and 90.9%, 64.8%, 40.8%, 96.4% and 70.2% respectively for a high risk score system (> or = 7 scores) alone. The specificity and positive predictive value were both further improved to 93.9% by combining a raised CA 125 level and high risk score of 7 or more as the predictive test. When used alone, the clinical risk scoring system picked up more FIGO stage I ovarian cancer than the raised serum CA 125 level. The findings of this study indicated that the risk scoring system is a useful predictor of malignant ovarian cysts. It needs to be assessed further in populations with different prevalence of ovarian cysts of various pathological types and malignancy before it can be advocated for general application, particularly in selecting ovarian cysts for laparoscopic surgery.
authors.affiliation: Department of Obstetrics and Gynaecology, Singapore General Hospital.
authors.forename: S K
authors.initials: SK
authors.lastname: Tay
mesh_terms: D000328:Adult; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010048:Ovarian Cysts / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D018394:CA-125 Antigen