IMEMR
66.92
Volume 4, Issue 3 (2023)                   J Clinic Care Skill 2023, 4(3): 167-173 | Back to browse issues page
Article Type:
Original Research |

Print XML PDF HTML

History

How to cite this article
Ghaffari P, Mahmoodi F, Sasani H. Diagnostic Value of Tumor Markers Compared to Ultrasound in the Diagnosis of Ovarian Tumors. J Clinic Care Skill 2023; 4 (3) :167-173
URL: http://jccs.yums.ac.ir/article-1-204-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Rights and permissions
1- Department of Obstetrics and Gynecology, Faculty of Medicine, Yasouj University of Medical Sciences, Yasouj, Iran
2- Department of Midwifery, Faculty of Medicine, Yasouj University of Medical Sciences, Yasouj, Iran , fatemeh.mahmoodii66@yahoo.com
3- Clinical Research Center of Imam Sajjad Hospital, Yasouj University of Medical Sciences, Yasouj, Iran
* Corresponding Author Address: Faculty of Medicine, Yasouj University of Medical Sciences, Shahid Dr. Mohammad Zarei Educational Campus, Shahid Gurban Ali Jalil Street, Yasouj, Iran. Postal Code: 7591994799
Abstract   (1660 Views)
Aims: Ovarian cancer has the worst prognosis among female genital tract malignancies, but if detected in the early stages, it is one of the most treatable malignancies. This study aimed to investigate the diagnostic value of tumor markers compared to ultrasound in the diagnosis of ovarian tumors.
Instruments & Methods: This cross-sectional-analytical study was conducted on 210 women referred to women's specialized clinic in Yasuj City, Iran, from 2017 to 2021 who were candidates for ovarian surgery. The method of data collection was patients interviewing and using the information available in the file. The data was analyzed using SPSS 22 software.
Findings: The most common histological pattern was ovarian epithelial masses (64.28%), of which 72.18% were larger than 10cm in ultrasound. There was a significant correlaion between the serum level of two tumor markers CA125 and HE4 in ovarian cancer (p=0.0001), but no correlaion was observed between the surgical stage and differentiation grade of ovarian cancer. The sensitivity of ultrasound was 78.9% and the sensitivity and specificity of HE4 tumor marker were 85.4% and 81.7%, respectively. The lowest specificity was related to the tumor marker CA125 (59.3%).
Conclusion: Ultrasound has relatively high sensitivity for detecting ovarian tumors, but CA125, with relatively high sensitivity and moderate specificity and HE4, with high specificity and high sensitivity, as two tumor markers, are not suitable for screening these tumors alone and should be performed together with ultrasound.
Keywords:

References
1. Pradhan A, Sinha A, Upreti D. Histopathological pattern of ovarian tumors at BPKIHS. Health Renaissance. 2016;10(2):87-97. [Link] [DOI:10.3126/hren.v10i2.6570]
2. Dochez V, Randet M, Renaudeau C, Dimet J, Le Thaut A, Winer N, et al. Efficacy of HE4, CA125, risk of malignancyindex and risk of Ovarian malignancy index to detect ovarian cancer in woman with presumed benign ovarian tumors: a prospective, multicenter trial. J Clin Med. 2019;8(11):1784. [Link] [DOI:10.3390/jcm8111784]
3. Khodabakhshi R, Yahyazadeh-Jabbari SH, Gohari MR, Shahidi J, Ameri A. Treatment and prognosis of epithelial ovarian cancer: five year multi-cancer study. Saudi Med J. 2008;29(12):1735-8. [Link]
4. Hasani M, Alizadeh S, Bastami P, Soheyli F. Investigation of the frequency of masses of ovarian lesions in different age groups. Iran J Obstet Gynecol Infertil. 2014;17(126):9- 16. [Persian] [Link]
5. Berek JS, Berek DL. Brerek and Novak's gynecology. 15th Edition. Lippincott Williams & Wilkins; 2011. [Link]
6. Kayastha S. Study of Ovarian tumors in Nepal Medical College Teaching Hospital. Nepal Med Coll J. 2009;11(1):200-2. [Link]
7. Cheraghi F, Zargar M, Bolkheir A. Correlation of preoperative HE-4 and CA125 with ovarian cancer staging in Ahvaz Imam Khomeni Hospital. Iran South Med J. 2020;22(6):371-80 [Persian] [Link] [DOI:10.29252/ismj.22.6.371]
8. Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz F. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era; a meta-analysis. J Clin Oncol. 2002;20(5):1248-59. [Link] [DOI:10.1200/JCO.2002.20.5.1248]
9. Ferraro S, Braga F, LanZoni M, Boracchi P, Biganzoli EM, Panteghini M. Serum human epididymis protein 4 vs carbohydrate antigen 125 for ovarian cancer diagnosis: a systematic review. J Clin Pathol. 2013;66(4):273-81. [Link] [DOI:10.1136/jclinpath-2012-201031]
10. Tehranian A, Ghahghaei-Nezamabadi A, Yarmohammadi N, Ganjeh M, Maajaani K, Aghajani R. Evaluation of diagnostic accuracy of RMI and ROMA indices in comparison to HE4 and CA125 parameters for estimating the risk of malignancy of adnexal masses. Tehran Univ Med J. 2021;79(3):193-200. [Persian] [Link]
11. Peak J, Lee SH, Yim GW, Lee GW, Kim YJ, Nam EJ, et al. Prognostic significance of human epididymis protein 4 in epithelial ovarian cancer. Eur J Obstet Gynecol Reprod Biol. 2011;158(2):338-42. [Link] [DOI:10.1016/j.ejogrb.2011.05.021]
12. Moor RG, Miller CM, Brown AK, Robison, K, Steinhoff M, Lambert-Messerlian G. Utility of tumor marker HE4 to predict depth of myometrial invasion in endometrioid adenocarcinoma of the uterus. Int J Gynecol Cancer. 2011:21(7);1185-90. [Link] [DOI:10.1097/IGC.0b013e3182229ad8]
13. AL-Musalhi K, Al-Kindi M, Ramadhan F, ALRawahi T, AL-Hatali K, Mula-Abed W-A. Validity of Cancer Antigen- 125 (CA-125) and Risk of Malignancy Index (RMI) in the Diagnosis of Ovarian Cancer. Oman Med J. 2015;30(6);428- 34. [Link] [DOI:10.5001/omj.2015.85]
14. Fini E, Nasirian N, Hosein Beigy B. Evaluating specivity, sensitivity, positive and negative predictive values of CA125 for diagnosing ovarian cancer. J Arak Uni Med Sci. 2021;24(2):196-203. [Persian] [Link] [DOI:10.32598/jams.24.2.6002.1]
15. Gocze P, Vahrson H. Ovarian carcinoma antigen (Ca- 125) and ovarian cancer (clinical follow-up and prognostic studies). Orv Hetil. 1993;134(17):915-8. [Hungarian] [Link]
16. Lycke M, Kristjansdottir B, Sundfeldt K. A multicenter clinical trial validating the performance of 4, CA125, risk of ovarian malignancy algorithm and risk of malignancy index. Gynecol Oncol. 2018;151(1);159-65. [Link] [DOI:10.1016/j.ygyno.2018.08.025]
17. Zhang P, Wang C, Cheng L, Zhang P, Guo L, Liu W, et al. Comparison of HE4, CA125 and ROMA diagnostic accuracy: a prospective and multicenter study for Chinese woman with epithelial ovarian cancer. Medicine. 2015;94(52):e2402. [Link] [DOI:10.1097/MD.0000000000002402]
18. Ranaei M, Gharavi F, Ghanbarpour A, Galeshi M, Yazdani S. The diagnostic value of ultrasound for ovarian mature cystic teratoma and accordance of it with postoperative histopathologic findings. Tehran Univ Med J. 2021;79(8):614-20. [Persian] [Link]
19. Tongsong T, Luewan S, Phadungkiatwattana P, Neeyalavira V, Wanapirak C, Khunamornpong S, et al. Pattern recognition using transabdominal ultrasound to diagnose ovarian mature cystic teratoma. Int J Gynecol Obstert. 2008;103(2):99-104. [Link] [DOI:10.1016/j.ijgo.2008.06.002]
20. Arab M, Maktabi M, Zham H, Kimiaei P, Davalo S. Is ovarian mass malignancy prediction accuracy increased by adding serum CA125 measurement to sonographic findings? Avicenna J Clin Med. 2012;18(4):37-40. [Link]
21. Dayyani F, Uhlig S, Colson B, Simon K, Rolny V, Morgestern D, et al. Diagnostic performance of risk of ovarian malignancy algorithm against CA125 and HE4 in connection with ovarian cancer: a meta-analysis. Int J Gyencol Cancer. 2016;26(9):338-46. [Link] [DOI:10.1097/IGC.0000000000000804]
22. Abdel-Azeez HA, Labib HA, Sharaf SM, Refai AN. HE4 and mesothelin; novel biomarkers of ovarian carcinoma in patients with pelvic masses. Asian Pac J Cancer Prev. 2010;11(1):111-6. [Link]
23. Yurkovetsky Z, Skates S, Lomakin A, Nolen B, Pulsipher T, Modugno F, et al. Development of a multimarket assay for early detection ovarian cancer. J Clin Oncol. 2010;28(13):2159-66. [Link] [DOI:10.1200/JCO.2008.19.2484]
24. Kurman RJ, Carcangiu ML, Herrington CS, Young RH. WHO classification of tomurs of female reproductive organs. 4th Edition. Geneva: World Health Organization; 2014. [Link]
25. Akhavan S, Pouseyed S, Afkhamzadeh A. Comparison of sonography and ct-scan in differentiation of benign and malignance ovarian tumors. Iran J Obstet Gynecol Infertil. 2014;17(92):1-8. [Persian] [Link]
26. Iqbal J, Aurangzaib, Naseem A, Shahid A. Pattern of ovarian pathologies. J Rawalpindi Med Coll. 2013;17(1);113-5. [Link]
27. Charles N, Nnenna N. A clinico-pathological evaluation of ovarian teratomas in Uyo, Nigeria during A10 year period. East African Med J. 2018;95(5):1595-606. [Link]