title: D-dimer as a tumor marker in pre-operative assessment of adnexal masses.
abstract: OBJECTIVE
  To determine the sensitivity, specificity, and predictive value ofserum D-dimer testing in preoperative assessment of adnexal masses.
  
  
  METHODS
  D-dimer levels were measured pre-operatively in 200 women diagnosed with adnexal masses who underwent surgical treatment at Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital between June 2007 and May 2008. The CA-125 level was also recorded
  
  
  RESULTS
  When using cut-off value at 500 ng/ml, D-dimer has 91.8% sensitivity, 71.9% specificity, 58.9% PPV and 95.2% NPV of the tests in differentiating benign from malignant adnexal masses, compared with CA-125, which had 75.4%, 73.0%, 59.7%, and 84.8% respectively (cut-off 65 U/ml). Furthermore, the likelihood ratio to be negative ofD-dimer test is high at 0.11. In patients with epithelial ovarian cancer, D-dimer is increased in 83% of early stage (stage 1) ovarian cancer while only 39% of early stage patients have CA-125 level above cut-off value.
  
  
  CONCLUSIONS
  D-dimer could be a useful test in pre-operative assessment of adnexal masses. In this study D-dimer seems to be better than CA-125 in diferentiating benign from malignant adnexal tumors.
authors.affiliation: Department of Obstetrics and Gynecology, Chulalongkorn University, Bangkok, Thailand. drjui@hotmail.com
authors.forename: Pongkasem
authors.initials: P
authors.lastname: Worasethsin
authors.affiliation: Department of Obstetrics and Gynecology, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Amarin
authors.initials: A
authors.lastname: Narkwichean
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis; D057234:Preoperative Period; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D