학술논문
Preoperative evaluation of ovarian tumors in the rural population--clinical features, grey scale ultrasound, colour Doppler, serum CA-125 and Alcazar score in predicting malignancy
Document Type
Report
Source
Journal of Evolution of Medical and Dental Sciences. April 22, 2013, Vol. 2 Issue 16, p2598, 12 p.
Subject
Language
English
ISSN
2278-4748
Abstract
INTRODUCTION: An adnexal mass is a common occurrence in clinical practice. The differential diagnosis varies from functional cyst to benign and malignant tumors of the ovary. (1) Epithelial ovarian cancer [...]
PURPOSE: Preoperative diagnosis of early ovarian malignancy is challenging. We evaluated clinical features and the performance of serum CA 125, ultrasonography, colour Doppler, and Alcazar score in diagnosing ovarian cancer. METHODS: This prospective study included 67 patients. Sono-morphological parameters studied were tumor size, bilaterality, wall irregularity, presence of solid component, septae, septae >3mm and ascites. Doppler parameters studied were blood flow, central vascularity, resistance index (RI) 15 cm/sec and velocimetry. Alcazar score was calculated. Findings on imaging were correlated with histopathology using univariate analysis. Receiver operator characteristic (ROC) curve of Alcazar score was plotted. RESULTS: Of 67 patients, 14 had malignant disease. Clinical features were not reliable in predicting malignancy. Sonomorphological features- irregular wall, septae >3mm, solid areas, mixed/heterogenous echotexture, bilaterality and ascites significantly correlated with malignancy while tumor size did not. On Doppler; increased blood flow, central vascularity and PSV>15 cm/sec significantly correlated with malignancy while RI KEYWORDS: ovarian tumor, ultrasound, Doppler, Alcazar score, CA 125
PURPOSE: Preoperative diagnosis of early ovarian malignancy is challenging. We evaluated clinical features and the performance of serum CA 125, ultrasonography, colour Doppler, and Alcazar score in diagnosing ovarian cancer. METHODS: This prospective study included 67 patients. Sono-morphological parameters studied were tumor size, bilaterality, wall irregularity, presence of solid component, septae, septae >3mm and ascites. Doppler parameters studied were blood flow, central vascularity, resistance index (RI) 15 cm/sec and velocimetry. Alcazar score was calculated. Findings on imaging were correlated with histopathology using univariate analysis. Receiver operator characteristic (ROC) curve of Alcazar score was plotted. RESULTS: Of 67 patients, 14 had malignant disease. Clinical features were not reliable in predicting malignancy. Sonomorphological features- irregular wall, septae >3mm, solid areas, mixed/heterogenous echotexture, bilaterality and ascites significantly correlated with malignancy while tumor size did not. On Doppler; increased blood flow, central vascularity and PSV>15 cm/sec significantly correlated with malignancy while RI KEYWORDS: ovarian tumor, ultrasound, Doppler, Alcazar score, CA 125