Women with a pelvic mass: indicators of malignancy.
OBJECTIVE
To evaluate the efficacy of five methods: pelvic examination (PE), transvaginal ultrasonography (US), Doppler ultrasonography, serum CA125 assay and serum CA72-4 assay, alone or associated, to predict malignancy in patients presenting a pelvic mass originating in the ovary.


METHODS
92 patients underwent a standard protocol for physical examination, CA125, CA72-4, transvaginal ultrasonography and Doppler ultrasonography.


RESULTS
Eighteen women were dropped from the study because they had clearly benign masses; two women were dropped from the study because they had clearly malignant lesions. Twenty-two malignant (30%) and 50 benign (70%) pelvic tumors were found. When one method was considered alone the best sensitivity (SENS) was found in physical examination (90%) and the best specificity (SPEC) was found in CA72-4: 88%. If all indicators were positive, the SPEC was 100% but the SENS was 40%. Logistic regression analysis prediction of the character of the pelvic masses was correct in 86%.


CONCLUSIONS
Some additional information to discriminate between malignant and benign pelvic masses can be obtained from the valuation of serum tumor markers, particularly CA72-4. Also Doppler ultrasonography appeared to be useful in the differential diagnosis of pelvic tumors. The prediction of the character of the pelvic masses calculated by a logistic model in which PE, US, CA 125, and CA72-4 are included is very good.
Balbi
G C
GC
II University of Naples, Obstetrics and Gynecology Clinic, Naples Italy.
Musone
R
R
Menditto
A
A
Balbi
F
F
Corcioni
C
C
Calabria
G
G
Maciariello
C
C
Balbi
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis; D018394:CA-125 Antigen / Q000032:analysis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D015295:Antigens, Tumor-Associated, Carbohydrate; D018394:CA-125 Antigen; C083825:CA-72-4 antigen