OC19.01: Additional value of CA‐125 to ultrasound for predicting specific diagnosis of benign adnexal cysts in premenopausal women

To assess whether a single determination of serum CA-125 provides additional information to ultrasound diagnosis for specific diagnosis of benign adnexal masses in premenopausal women. Retrospective study comprising 1058 premenopausal women (mean age: 34.8 years) with histologically proven benign adnexal masses. All women had undergone transvaginal ultrasound and serum CA-125 determination within one week prior to surgery and tumor removal. According to ‘pattern recognition’ analysis a presumptive diagnosis was provided on gray-scale transvaginal ultrasound for all masses. Positive (LR + ) and negative (LR−) likelihood ratios were calculated for gray-scale and gray-scale + CA-125. Eighty-five women had bilateral masses (1143 masses analyzed). Histologic diagnoses were as follows: endometrioma (n = 454), dermoid cyst (n = 182), serous cyst (n = 162), hemorrhagic cyst (n = 120), mucinous cyst (n = 56), hydrosalpinx (n = 38), other (n = 111). Median CA-125 value was significantly higher in endometrioma (71.9 UI/mL, range: 5 to 2615) and hydrosalpinx (59.2 UI/mL, range: 5 to 601) as compared to all other kind of cysts (P 35 UI/mL in 74% of endometriomas, 58% of hydrosalpinges, 34% of hemorrhagic cysts, 18% of mucinous cysts, 14% of dermoid cysts and 8% of serous cysts. LRs for ultrasound and ultrasound + CA-125 (> 35 UI/mL) for each kind of tumor are shown in Table 1. CA-125 does not add useful information for specific diagnosis of benign adnexal tumors, except for the case of endometrioma. An elevated CA-125 increases significantly the probability of such a lesion.