Ultrasound Criteria and CA-125 for Evaluation of Adenexal Masses in Developing Countries

Abstract

Objectives: Ovarian malignancy being one of the most common among genital malignancy, ascendant importance has to be given to evaluate it pre-operatively with high degree of precision. It is of crowning importance because it helps to tailor neo-adjuvant chemotherapy, chemoradiation, radiotherapy and surgery. This study correlates between the clinical and HPE findings to prove that though USG helps in detection and characterization of adnexal lesion to some extent, its diagnostic ability is further improved by addition of a simple parameter CA-125. Methods: This study is a prospective observational study carried out between January 1, 2016 to 30 June, 2017 in the department of Obs and Gynae, RHP, Patiala. All cases of ovarian masses who underwent USG and CA-125 & were followed with laparotomy, followed by HPE of the specimen, were included in the study. Results: 55 patients were included in the evaluation. The specificity 86% of USG was enhanced to 88% on addition of CA-125 to the study. The specificity increased further to 94% when clinical examination, USG and CA-125 were combined. Sensitivity was 100% with all the three methods. Conclusion: Optimal pre-operative evaluation was achieved with USG. But when combined with clinical features & CA-125, the diagnostic value is extremely high. This aids in planning the management.