Color Doppler ultrasonography and serum CA 125 were used to evaluate 114 adnexal tumors prior to surgery. Six patients were excluded from this study because of ovarian cancer, borderline ovarian malignancy, and tubal gestation. A total of 108 patients were eligible: 83 patients with benign and 25 patients with malignant ovarian tumors. Resistance index (RI) was used to determine the peripheral resistance of intratumoral vessels. The cutoff point for the RI was defined as 0.5. The blood flow was considered to be normal when the RI was greater than 0.5 and abnormal when it was less than 0.5. The blood flow was detected in 100% of malignant tumors and 59% of benign tumors. The initial cutoff value for CA 125 was 35 U/mL. Sensitivity, specificity, positive predictive value, and negative predictive value were compared in terms of RI, serum CA 125, and a combination of the two. Our conclusion is that the combination of RI and CA 125 gives a sensitivity of 100% and negative predictive value of 100%. If the cutoff point of CA 125 was raised from 35 to 65 U/mL, then a specificity of 100% and positive predictive value of 100% were also attained with the use of RI and CA 125 without changes in sensitivity or negative predictive value. We conclude that the combination of color Doppler ultrasonography and serum CA 125 is an effective method to differentiate benign from malignant ovarian tumors.
Background. The benefit of postoperative adjuvant therapy for patients with cervical cancer is uncertain, and moreover, may increase morbidity. In this study, patient age, clinical stage of the cancer, tumor size, and levels of serum squamous cell carcinoma cell antigen and carcinoembryonic antigen were studied in patients with Stage Ib and IIa squamous cell carcinoma of the uterine cervix to determine if these parameters can be used, be fore the surgical intervention, to distinguish patients who require postoperative adjuvant therapy from those who do not.
Methods. Ninety‐nine patients were studied. After surgery, patients were classified either as high risk or low risk according to the results of histopathologic findings. The age of the patient was noted, and FIGO stage, squamous cell carcinoma antigen, carcinoembryonic antigen, and clinical tumor size were determined. A univariate analysis and then a stepwise logistic regression procedure were performed to select significant clinical predictors from among the five variables mentioned above. Any selected predictors were further analyzed by the receiver operator characteristic curve.
Results. Serum squamous cell carcinoma antigen and clinical tumor size measured by colposcopic examination were significant clinical predictors of the treatment strategy postoperatively. From the receiver operator characteristic curve, a sensitivity of 84.2%, a specificity of 91.8%, a positive predictive value of 84.5% were attained.
Conclusions. Serum squamous cell carcinoma antigen assays and clinical tumor size estimated by colpos copic examination are helpful in identifying patients who require postoperative adjunctive therapy.
The purpose of this study was to test the hypothesis that the acceleration time (AT) of the fetal umbilical artery remains constant at term for normal pregnancies. In addition, we also examined whether the AT has any correlation with umbilical cord blood hematocrit (Hct). In total, 539 normal-term fetuses with menstrual ages (MA) ranging from 37 weeks to 42 weeks were enrolled in a cross-sectional design. The AT of the fetal umbilical artery was measured prior to delivery using a high-resolution, real-time Doppler scanner. All were delivered within 2 days of the ultrasound examination. At parturition, blood from the umbilical vein was collected and the red cell indices, including the Hct, were determined. The results indicated that the mean values of AT of the umbilical artery remained constant during normal-term pregnancies from 37 weeks to 42 weeks, menstrual age (mean: 0.104 sec, SE: 0.001 sec, n = 539). Although the AT was thought to be affected by the Hct, the AT had no correlation with umbilical venous Hct (n = 539, r = 0.002, p > 0.05). This constant value of the AT may be used as a reference for fetal physiology and perinatal medicine.
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