Correlation of Cancer Antigen 125 Levels with Adnexal Masses

Abstract

Background: Adnexal masses can be of varied etiology. It may be benign like luteal cyst, infective like
abscess or malignant like ovarian cancer. These masses are detected on pelvic or abdominal examination
and sometimes incidentally found on ultrasonographic evaluation. Adnexal masses manifests with a wide
spectrum of clinical, morphological and histological features. Cancer Antigen 125 is a marker in the blood
that is known to be elevated in women with ovarian cancer, but also in people with other medical conditions
and in some healthy people. This biomarker can be useful when an ovarian mass is felt on examination or
seen on ultrasound and the physician is unsure whether it is ovarian cancer. The Aims and Objectives was to
study the diagnostic value of Cancer Antigen 125 in adnexal masses, the correlation of this tumour marker
with type of adnexal masses.
Material and Method: Fifty patients from reproductive to postmenopausal age group meeting the inclusion
and exclusion criteria with adnexal mass were taken. Thorough history taking, clinical examination,
laboratory investigation including CA 125 and histopathological evaluation was done.
Results: The mean age was found to be 42.3 ± 11.1 years. Of fifty cases 80% were benign and 20% were
malignant in histopathology. Maximum number of cases (54%) were with parity between 1-3. Clinical
presentation had no clear predictive value in malignant or benign nature of the mass. In our study CA125 has
a sensitivity of 90% and specificity of 35% . Positive predictive value was 25.71% and negative predictive
value of 93.3%.
Conclusion: The detection of pelvic mass with an associated elevated CA 125 is highly suspicious of ovarian
cancer, but there are various benign conditions which mimic the above findings, especially in premenopausal
women.