Clinical Significance of Thrombocytosis and CA125 as Predictor of Malignancy in Gynecological Pelvic Mass

Abstract

Article InfoWe attempted to determine the increasing of platelet counts (> 450.000 /microliter) and Cancer Antigen 125 (CA125) serum level (> 35 U/mL) as useful tools for predicting and confirming malignancy in gynaecological pelvic mass. A prospective unmatched hospital based case-control study carried out about One hundred & ten women were enrolled in our study, divided into two group 60 women were control group (free of gynaecological pelvic mass) which were considered as -eligible entrants‖ into the study. Other group include 50 women above 15 years old with gynaecological pelvic mass were all candidate for laparotomy and using different diagnostic methods like clinical examination, imaging techniques (U/S, CT scan and MRI) and laboratory test (platelet count, CA125 and Histopathology). The data of those were subjected to statistical analysis (sensitivity, specificity, accuracy, NPV and PPV) which calculated to considered if it is statistically significant or not. Serum CA125 and blood platelets count were tested for validity when used as a test to predict a diagnosis of malignancy in gynaecological pelvic mass differentiating it from benign gynaecological pelvic mass. Both tests showed a very high validity in diagnosis (ROC area >0.95), with serum CA125 showing a marginally higher validity (ROC area larger by 0.017 only). Both ROC areas were significantly higher than the 0.5 area associated with an equivocal test. Platelets counts had a perfect cut-off value of ≥385.000 All study subjects with a blood platelets count equal or greater than 385.000 were malignant, while everybody below this cut-off value was healthy. For serum CA125 testing negative at the highest sensitivity (100% sensitive) cut-off value of (≥27.1( would excluded a possible diagnosis of malignancy in favor of being healthy with 100% confidence. The optimum cut-off value is ≥41.7, which is also the 100% specific and thus 100% diagnostic cut-off value. Both blood platelet count (≥ 385 X 10 3 microlitter) & serum level of CA125 (≥ 41.7 U/mL) are useful predictor tools to confirm malignancy in gynecological pelvic mass.