Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

The Serum CA-125 Concentration Data Assists in Evaluating CT Imaging Information When Used to Differentiate Borderline Ovarian Tumor from Malignant Epithelial Ovarian Tumors

  • Shin, Ji-Eun (Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Choi, Hyuck-Jae (Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Mi-Hyun (Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Cho, Kyoung-Sik (Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
  • Published : 2011.08.01
⟨ Previous Next ⟩

Abstract

Objective: We wanted to evaluate the diagnostic value of serum CA-125 concentration, when used in combination with the preoperative contrast-enhanced CT results, to differentiate borderline ovarian tumors (BOTs) from stage I malignant epithelial ovarian tumors (MEOTs). Materials and Methods: Ninety-eight masses (46 BOTs and 52 stage I MEOTs) from 87 consecutive patients (49 with BOTs and 38 with stage I MEOTs) who had undergone preoperative contrast-enhanced computed tomography (CT) and surgical staging were evaluated retrospectively and independently by two radiologists. The preoperative serum CA-125 concentration was measured in all patients. The utility of analyzing serum CA-125 concentration in combination with the CT results was evaluated by receiver operating characteristic (ROC) curve analysis. Results: An irregular tumor surface and lymphadenopathy were predictive of a MEOT. ROC analysis showed that the combination of CT data and the serum CA-125 level resulted in a higher diagnostic performance than did using the CT alone for differentiating BOTs from MEOTs. The areas under the curves (AUCs) without and with the use of the serum CA-125 level data were 0.67 (95% confidence interval [CI]: 0.57-0.77) and 0.78 (95% CI: 0.68-0.85), respectively, for reader 1 (p = 0.029) and 0.71 (95% CI: 0.61-0.80) and 0.81 (95% CI: 0.72-0.89), respectively, for reader 2 (p = 0.009). Conclusion: The serum CA-125 concentration is of additional diagnostic value when used in conjunction with the CT imaging results for differentiating BOTs from MEOTs.

Keywords

References

  1. Jones MB. Borderline ovarian tumors: current concepts for prognostic factors and clinical management. Clin Obstet Gynecol 2006;49:517-525 https://doi.org/10.1097/00003081-200609000-00011
  2. Bell DA, Longacre TA, Prat J, Kohn EC, Soslow RA, Ellenson LH, et al. Serous borderline (low malignant potential, atypical proliferative) ovarian tumors: workshop perspectives. Hum Pathol 2004;35:934-948 https://doi.org/10.1016/j.humpath.2004.03.005
  3. Tinelli R, Tinelli A, Tinelli FG, Cicinelli E, Malvasi A. Conservative surgery for borderline ovarian tumors: a review. Gynecol Oncol 2006;100:185-191 https://doi.org/10.1016/j.ygyno.2005.09.021
  4. Cadron I, Leunen K, Van Gorp T, Amant F, Neven P, Vergote I. Management of borderline ovarian neoplasms. J Clin Oncol 2007;25:2928-2937 https://doi.org/10.1200/JCO.2007.10.8076
  5. Holschneider CH, Berek JS. Valvar cancer. In: Berek JS, Novak E, eds. Berek & Novak's gynecology, 14th ed. Philadelphia: Lippincott Williams & Wilkins, 2007:1549-1580
  6. Pignata S, Cannella L, Leopardo D, Pisano C, Bruni GS, Facchini G. Chemotherapy in epithelial ovarian cancer. Cancer Lett 2011;303:73-83 https://doi.org/10.1016/j.canlet.2011.01.026
  7. Buy JN, Ghossain MA, Sciot C, Bazot M, Guinet C, Prevot S, et al. Epithelial tumors of the ovary: CT findings and correlation with US. Radiology 1991;178:811-818 https://doi.org/10.1148/radiology.178.3.1994423
  8. Dobson M, Carrington BM, Radford JA, Buckley CH, Crowther D. The role of computed tomography in the management of ovarian tumours of borderline malignancy. Clin Radiol 1997;52:280-283 https://doi.org/10.1016/S0009-9260(97)80054-2
  9. Grab D, Flock F, Stohr I, Nussle K, Rieber A, Fenchel S, et al. Classification of asymptomatic adnexal masses by ultrasound, magnetic resonance imaging, and positron emission tomography. Gynecol Oncol 2000;77:454-459 https://doi.org/10.1006/gyno.2000.5768
  10. Rieber A, Nussle K, Stohr I, Grab D, Fenchel S, Kreienberg R, et al. Preoperative diagnosis of ovarian tumors with MR imaging: comparison with transvaginal sonography, positron emission tomography, and histologic findings. AJR Am J Roentgenol 2001;177:123-129 https://doi.org/10.2214/ajr.177.1.1770123
  11. deSouza NM, O'Neill R, McIndoe GA, Dina R, Soutter WP. Borderline tumors of the ovary: CT and MRI features and tumor markers in differentiation from stage I disease. AJR Am J Roentgenol 2005;184:999-1003 https://doi.org/10.2214/ajr.184.3.01840999
  12. Van Calster B, Timmerman D, Bourne T, Testa AC, Van Holsbeke C, Domali E, et al. Discrimination between benign and malignant adnexal masses by specialist ultrasound examination versus serum CA-125. J Natl Cancer Inst 2007;99:1706-1714 https://doi.org/10.1093/jnci/djm199
  13. Zhang J, Mironov S, Hricak H, Ishill NM, Moskowitz CS, Soslow RA, et al. Characterization of adnexal masses using feature analysis at contrast-enhanced helical computed tomography. J Comput Assist Tomogr 2008;32:533-540 https://doi.org/10.1097/RCT.0b013e3181568890
  14. Brown DL, Zou KH, Tempany CM, Frates MC, Silverman SG, McNeil BJ, et al. Primary versus secondary ovarian malignancy: imaging findings of adnexal masses in the Radiology Diagnostic Oncology Group Study. Radiology 2001;219:213-218 https://doi.org/10.1148/radiology.219.1.r01ap28213
  15. Choi HJ, Lee JH, Kang S, Seo SS, Choi JI, Lee S, et al. Contrast-enhanced CT for differentiation of ovarian metastasis from gastrointestinal tract cancer: stomach cancer versus colon cancer. AJR Am J Roentgenol 2006;187:741-745 https://doi.org/10.2214/AJR.05.0944
  16. Jang YJ, Kim JK, Park SB, Cho KS. Variable CT findings of epithelial origin ovarian carcinoma according to the degree of histologic differentiation. Korean J Radiol 2007;8:120-126 https://doi.org/10.3348/kjr.2007.8.2.120
  17. Jung DC, Kim SH. MR imaging findings of ovarian cystadenofibroma and cystadenocarcinofibroma: clues for the differential diagnosis. Korean J Radiol 2006;7:199-204 https://doi.org/10.3348/kjr.2006.7.3.199
  18. Jacobs IJ, Skates S, Davies AP, Woolas RP, Jeyerajah A, Weidemann P, et al. Risk of diagnosis of ovarian cancer after raised serum CA 125 concentration: a prospective cohort study. BMJ 1996;313:1355-1358 https://doi.org/10.1136/bmj.313.7069.1355
  19. Paramasivam S, Tripcony L, Crandon A, Quinn M, Hammond I, Marsden D, et al. Prognostic importance of preoperative CA-125 in International Federation of Gynecology and Obstetrics stage I epithelial ovarian cancer: an Australian multicenter study. J Clin Oncol 2005;23:5938-5942 https://doi.org/10.1200/JCO.2005.08.151

Cited by

  1. Genital Schistosomiasis: A Report on Two Cases of Ovarian Carcinomas Containing Viable Eggs of Schistosoma mansoni vol.2014, pp.None, 2011, https://doi.org/10.1155/2014/508718
  2. Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation? vol.17, pp.5, 2016, https://doi.org/10.3348/kjr.2016.17.5.706
  3. Combination of serum CA19-9 and CA125 levels and contrast-enhanced ultrasound parametric data facilitates to differentiate ovarian serous carcinoma from ovarian malignant epithelial cancer vol.97, pp.16, 2018, https://doi.org/10.1097/md.0000000000010358