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Discrimination between benign and malignant adnexal masses by specialist ultrasound examination versus serum CA-125

Van Calster, Ben; Timmerman, Dirk; Bourne, Tom; Testa, Antonia Carla; Van Holsbeke, Caroline; Domali, Ekaterini; Jurkovic, Davor; Neven, Patrick; Van Huffel, Sabine and Valentin, Lil LU (2007) In Journal of the National Cancer Institute 99(22). p.1706-1714
Abstract
Background Subjective evaluation of gray-scale and Doppler ultrasound findings (i. e., pattern recognition) by an experienced examiner and preoperative serum levels of CA-125 can both discriminate benign from malignant adnexal ( i. e., ovarian, paraovarian, or tubal) masses. We compared the diagnostic performance of these methods in a large multicenter study. Methods In a prospective multicenter study-the International Ovarian Tumor Analysis-1066 women with a persistent adnexal mass underwent transvaginal gray-scale and color Doppler ultrasound examinations by an experienced examiner within 120 days of surgery. Pattern recognition was used to classify a mass as benign or malignant. Of these women, 809 also had blood collected... (More)
Background Subjective evaluation of gray-scale and Doppler ultrasound findings (i. e., pattern recognition) by an experienced examiner and preoperative serum levels of CA-125 can both discriminate benign from malignant adnexal ( i. e., ovarian, paraovarian, or tubal) masses. We compared the diagnostic performance of these methods in a large multicenter study. Methods In a prospective multicenter study-the International Ovarian Tumor Analysis-1066 women with a persistent adnexal mass underwent transvaginal gray-scale and color Doppler ultrasound examinations by an experienced examiner within 120 days of surgery. Pattern recognition was used to classify a mass as benign or malignant. Of these women, 809 also had blood collected preoperatively for measurement of serum CA-125. Various levels of CA-125 were used as cutoffs to classify masses. Results from both assays were then compared with histologic findings after surgery. Results Pattern recognition correctly classified 93% (95% confidence interval [CI]=90.9% to 94.6%) of the tumors as benign or malignant. Serum CA-125 correctly classified at best 83% ( 95% CI=80.3% to 85.6%) of the masses. Histologic diagnoses that were most often misclassified by CA-125 were fibroma, endometrioma, and abscess ( false-positive results) and borderline tumor ( false-negative results). Pattern recognition correctly classified 86% ( 95% CI=81.1% to 90.4%) of masses of these four histologic types as being benign or malignant, whereas a serum CA-125 at a cutoff of 30 U/mL correctly classified 41% ( 95% CI=34.4% to 47.5%) of them. Pattern recognition assigned a correct specific histologic diagnosis to 333 (59%, 95% CI=54.5% to 62.8%) of the 567 benign lesions. Conclusion Pattern recognition was superior to serum CA-125 for discrimination between benign and malignant adnexal masses. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of the National Cancer Institute
volume
99
issue
22
pages
1706 - 1714
publisher
Oxford University Press
external identifiers
  • wos:000251072000012
  • scopus:38449099099
ISSN
1460-2105
DOI
10.1093/jnci/djm199
language
English
LU publication?
yes
id
c1b46c84-bda3-4cf2-a0db-29b7c02fb29b (old id 974299)
date added to LUP
2008-01-30 09:40:05
date last changed
2017-10-22 04:44:34
@article{c1b46c84-bda3-4cf2-a0db-29b7c02fb29b,
  abstract     = {Background Subjective evaluation of gray-scale and Doppler ultrasound findings (i. e., pattern recognition) by an experienced examiner and preoperative serum levels of CA-125 can both discriminate benign from malignant adnexal ( i. e., ovarian, paraovarian, or tubal) masses. We compared the diagnostic performance of these methods in a large multicenter study. Methods In a prospective multicenter study-the International Ovarian Tumor Analysis-1066 women with a persistent adnexal mass underwent transvaginal gray-scale and color Doppler ultrasound examinations by an experienced examiner within 120 days of surgery. Pattern recognition was used to classify a mass as benign or malignant. Of these women, 809 also had blood collected preoperatively for measurement of serum CA-125. Various levels of CA-125 were used as cutoffs to classify masses. Results from both assays were then compared with histologic findings after surgery. Results Pattern recognition correctly classified 93% (95% confidence interval [CI]=90.9% to 94.6%) of the tumors as benign or malignant. Serum CA-125 correctly classified at best 83% ( 95% CI=80.3% to 85.6%) of the masses. Histologic diagnoses that were most often misclassified by CA-125 were fibroma, endometrioma, and abscess ( false-positive results) and borderline tumor ( false-negative results). Pattern recognition correctly classified 86% ( 95% CI=81.1% to 90.4%) of masses of these four histologic types as being benign or malignant, whereas a serum CA-125 at a cutoff of 30 U/mL correctly classified 41% ( 95% CI=34.4% to 47.5%) of them. Pattern recognition assigned a correct specific histologic diagnosis to 333 (59%, 95% CI=54.5% to 62.8%) of the 567 benign lesions. Conclusion Pattern recognition was superior to serum CA-125 for discrimination between benign and malignant adnexal masses.},
  author       = {Van Calster, Ben and Timmerman, Dirk and Bourne, Tom and Testa, Antonia Carla and Van Holsbeke, Caroline and Domali, Ekaterini and Jurkovic, Davor and Neven, Patrick and Van Huffel, Sabine and Valentin, Lil},
  issn         = {1460-2105},
  language     = {eng},
  number       = {22},
  pages        = {1706--1714},
  publisher    = {Oxford University Press},
  series       = {Journal of the National Cancer Institute},
  title        = {Discrimination between benign and malignant adnexal masses by specialist ultrasound examination versus serum CA-125},
  url          = {http://dx.doi.org/10.1093/jnci/djm199},
  volume       = {99},
  year         = {2007},
}