title: CA 125 measurement and ultrasonography in borderline tumors of the ovary.
abstract: OBJECTIVE
  Our goal was to perform an analysis of ultrasonographic characteristics and CA 125 levels in ovarian tumors of borderline malignancy.
  
  
  METHODS
  We performed a retrospective analysis of CA 125 levels and ultrasonographic parameters in 91 patients with borderline tumors.
  
  
  RESULTS
  Serous tumors of borderline malignancy were associated with elevated CA 125 levels in 75% of patients before surgery (mean, 156 IU/mL) compared with 30% of mucinous tumors (mean, 28 IU/mL; P =.004). CA 125 was elevated in 35% of stage IA serous tumors (mean, 67 IU/mL) compared with 89% of tumors with spread beyond the ovary (mean, 259 IU/mL; P =.001). Mucinous tumors tended to be bigger (13.1 +/- 7 cm) on ultrasonography than serous tumors (9.3 +/- 6.2 cm, P =.016). Mucinous tumors were multilocular in half the patients and contained papillations in 40% of the patients. Serous tumors were multilocular in 30% of the patients but presented with solid or papillary patterns in 78% of the patients (P =.001). A resistance index of <0.4 was found in 36% of mucinous tumors and half the cases of serous tumors. In 13% of patients, ultrasonographic characteristics were compatible with a simple cyst only, including 1 patient with microinvasion and 1 patient with stage IIIB disease. Sensitivity of gray-scale ultrasonography was 87%, that of CA 125 measurement was 62%, and that of flow was 55%. At least 1 diagnostic test result was abnormal in 93% of patients, 2 were abnormal in 69% of patients, and all 3 were abnormal in 21% of patients.
  
  
  CONCLUSIONS
  A high proportion of borderline tumors of the ovary, particularly of the serous type, were associated with elevated CA 125 levels and abnormal ultrasonographic characteristics, although some tumors presented as simple cysts.
authors.affiliation: Division of Gynecologic Oncology, the Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel Aviv University, Israel.
authors.forename: W H
authors.initials: WH
authors.lastname: Gotlieb
authors.forename: D
authors.initials: D
authors.lastname: Soriano
authors.forename: R
authors.initials: R
authors.lastname: Achiron
authors.forename: Y
authors.initials: Y
authors.lastname: Zalel
authors.forename: B
authors.initials: B
authors.lastname: Davidson
authors.forename: J
authors.initials: J
authors.lastname: Kopolovic
authors.forename: I
authors.initials: I
authors.lastname: Novikov
authors.forename: G
authors.initials: G
authors.lastname: Ben-Baruch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018394:CA-125 Antigen / Q000097:blood*; D018282:Cystadenocarcinoma, Mucinous / Q000097:blood / Q000000981:diagnostic imaging; D018284:Cystadenocarcinoma, Serous / Q000097:blood / Q000000981:diagnostic imaging; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010048:Ovarian Cysts / Q000000981:diagnostic imaging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D018394:CA-125 Antigen