title: Ultrasonographic markers and preoperative CA-125 to distinguish between borderline ovarian tumors and stage I ovarian cancer.
abstract: OBJECTIVE
  Preoperative evaluation of ovarian masses has become increasingly important for optimal planning of treatment. The aim of this study was to assess the role of preoperative serum cancer antigen 125 (CA-125) levels in correlation with ultrasonographic features in order to distinguish between borderline ovarian tumors (BOTs) and stage I epithelial ovarian carcinoma (EOC).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary University Hospital.
  
  
  METHODS
  We reviewed all women with BOTs and stage I EOC from January 2000 to December 2010. Data from 165 women (66 BOTs and 99 stage I EOC) were analyzed.
  
  
  METHODS
  Multivariable logistic regression with stepwise selection of variables was used to determine which clinical variables, ultrasound features and CA-125 level were independently associated with invasiveness.
  
  
  METHODS
  Utility of ultrasonographic markers and CA-125 in the preoperative differential diagnosis between BOTs and stage I EOC.
  
  
  RESULTS
  Women with CA-125 > 100 IU mL(-1)  had almost three times greater likelihood of belonging in the EOC group [odds ratio (OR) 3.02; confidence interval (CI) 95%: 1.13-8.12]. Furthermore, the presence of large solid component (≥20% of the tumor comprised of solid components) was associated with 4.25 times greater odds of it to representing ovarian cancer rather than a BOT (OR 4.25; 95% CI: 2.05-8.82). In contrast, the presence of papillary projections was associated with a 73% lower likelihood of EOC (OR 0.27; 95% CI: 0.13-0.58).
  
  
  CONCLUSIONS
  Preoperative CA-125 > 100 IU mL(-1)  combined with the presence of a large solid component and the absence of papillary projections seems to improve the discriminative ability in favor of stage I EOC.
authors.affiliation: First Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece. dimzac@hotmail.com
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Zacharakis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Thomakos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Biliatis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Rodolakis
authors.forename: Maria
authors.initials: M
authors.lastname: Simou
authors.forename: Georgios
authors.initials: G
authors.lastname: Daskalakis
authors.forename: Aris
authors.initials: A
authors.lastname: Bamias
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D002277:Carcinoma / Q000097:blood* / Q000000981:diagnostic imaging*; D000077216:Carcinoma, Ovarian Epithelial; D016001:Confidence Intervals; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000000981:diagnostic imaging*; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen