Diagnostic Efficacy of Tumor Markers, Sonography, and Intraoperative Frozen Section for Ovarian Tumors

• Published in: Gynecologic and obstetric investigation Vol. 52; no. 3; pp. 147 - 152
• Main Authors: Wakahara, Fumiyo, Kikkawa, Fumitaka, Nawa, Akihiro, Tamakoshi, Koji, Ino, Kazuhiko, Maeda, Osamu, Kawai, Michiyasu, Mizutani, Shigehiko
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2001; S. Karger AG
• Subjects: Adolescent; Adult; Aged; Antigens, Tumor-Associated, Carbohydrate - blood; Biological and medical sciences; Biomarkers, Tumor - blood; CA-125 Antigen - blood; CA-19-9 Antigen - blood; Child; Diagnosis, Differential; Female; Female genital diseases; Frozen Sections; Gynecology. Andrology. Obstetrics; Histocytochemistry; Humans; Logistic Models; Medical sciences; Middle Aged; Original Paper; Ovarian Neoplasms - blood; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - diagnostic imaging; Ovarian Neoplasms - pathology; ROC Curve; Sensitivity and Specificity; Tumors; Ultrasonography, Doppler; Tumor marker; Ovarian carcinoma; Frozen section; Ultrasonography; Sonography; Human; Intraoperative; Malignancy; Tumoral marker; Differential diagnostic; Female genital diseases; Blood plasma; Ovarian diseases; Pathology; Ovary; Sensitivity; Specificity; Echography; Female; Tumor; Diagnosis
• ISSN: 0378-7346; 1423-002X
• DOI: 10.1159/000052963

Using sonography, we classified the adnexal masses of 292 patients into 4 patterns. Pattern A was benign cystic tumors; B was benign mixed tumors (cysts with a smooth solid component); C was malignant mixed tumors (cysts with an irregular solid component or thickened septum), and D was solid tumors. We diagnosed tumors showing patterns A and B as benign, while patterns C and D represented tumors with low malignant potential or actual malignancy. The sensitivity and specificity of sonography was 82.2 and 82.1%, respectively, and these values were superior to those for tumor markers (CA125, CA19-9, CA72-4). Both the sensitivity and specificity of intraoperative frozen sections were the highest, showing that this is the most reliable examination. However, 15 of 191 patients undergoing frozen section were upgraded by the final pathological diagnosis. If sonography is performed by an experienced gynecologic oncologist, this examination is more reliable than tumor markers. However, intraoperative frozen section should still be performed during surgery for patients with ovarian tumors.