Performance of Ultrasound as a Second Line Test to Serum Ca125 in Ovarian Cancer Screening in Postmenopausal Women
Iraqi Postgraduate Medical Journal,
2014, Volume 13, Issue 1, Pages 29-36
Epithelial ovarian cancer is uncommon before 40 years of age but the incidence then rises steeply until the mid sixth and seventh decades for which performance of transvaginal ultrasonography as a screening test for ovarian cancer in asymptomatic postmenopausal women with an elevated serum CA 125 had been performed.
Prospective ovarian cancer screening trial had been performed to estimate sensitivity, specifity and positive predictive value of different ultrasound criteria for detection of index cancer (e.g. primary invasive epithelial carcinoma of ovary) in postmenopausal women.
PATIENTS AND METHODS:
This study was carried out at the department of obstetrics and gynecology in AL-Yarmouk Teaching Hospital from October 2002 through October2003.The study included 110 Postmenopausal women ≥ 45 years, they underwent measurement of serum CA125.Women with CA 125 of 30 IU/ml (or more) were recalled for an ultrasound examination.
Of the 110 women included in this study, 9 women underwent 30 scans during a follow up of one year. The sensitivity for detection of ovarian cancer of different ultrasound criteria was 100% for abnormal ovarian morphology, 100% for abnormal ovarian volume and 50% for complex abnormal ovarian morphology. The highest specificity (100%) and positive predictive value (100 %) was achieved by using complex abnormal ovarian morphology.
A variety of ultrasound criteria had achieved high sensitivity, specificity and positive predictive value for ovarian cancer screening in postmenopausal women with an elevated CA 125. Ovarian morphology and ovarian volume used to interpret ultrasound had achieved increased sensitivity for ovarian cancer screening. While complex abnormal ovarian morphology had achieved increased in the specificity and the positive predictive value for ovarian cancer screening.
KEYWORDS: ovarian cancer, CA125, transvaginal ultrasound.
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