Women with a pelvic mass: Indicators of malignancy

Objective: To evaluate thè efficacy of five methods: pelvic examination (PE), transvaginal ultrasonography (US), Doppler ultra-sonography, serum CAI25 assay and serum CA72-4 assay, alone or associated, to predict malignancy in patients presenting a pelvic mass originating in thè ovary. Methods: 92 patients underwent a standard protocol for physical examination, CAI25, CA72-4, transvaginal ultrasonography and Doppler ultrasonography. Results: Eighteen women were dropped from thè study because they had clearly benign masses; two women were dropped from thè study because they had clearly malignant lesions. Twenty-two malignant (30%) and 50 benign (70%) pelvic tumore were found. When one method was considered alone thè best sensitivity (SENS) was found in physical examination (90%) and thè best speci-ficity (SPEC) was found in CA72-4: 88%. If ali indicators were positive, thè SPEC was 100% but thè SENS was 40%. Logistic regression analysis prediction of thè character of thè pelvic masses was correct in 86%. Conclusion: Some additional information to discriminate between malignant and benign pelvic masses can be obtained from thè valuation of serum tumor markers, particularly CA72-4. Also Doppler ultrasonography appeared to be useful in thè differential diag-nosis of pelvic tumors. The prediction of thè character of thè pelvic masses calculated by a logistic model in which PE, US, CA 125, and CA72-4 are included is very good.