Diagnostic value of the morphological ultrasound score system and the serum concentration of CA 125 in the diagnosis of malignant ovarian cancer

OBJECTIVES: The aim of this study was to estimate the diagnostic value of the morphological ultrasound score system and the serum concentration of CA 125 in the diagnosis of malignant ovarian masses. The aim was realized by the evaluation of the statistical coefficients like sensitivity, specificity, positive predictive value and negative predictive value in three groups tested by different methods (A--ultrasonography, B--serum concentration of CA 125, C--both methods). MATERIALS AND METHODS: We have analyzed 59 patients (17-77 years old)--mean 46.5 +/- 14.8 with ovarian malignant masses diagnosed in years 1999-2001. RESULTS: Merz morphological ultrasound score system revealed its sensitivity of 92.3%, specificity--87.9%, positive predictive value--85.7% and negative predictive value--93.7%. Statistical coefficients for serum Ca 125 marker concentration was not so attractive: sensitivity--57.7%, specificity--90.9%, positive predictive value--83.4% and negative predictive value--73.2%. Using both methods at the same time we obtained significantly different coefficients: sensitivity--96.2%, specificity--80.0%, positive predictive value--78.1% and negative predictive value--96.6%. CONCLUSIONS: Ultrasound assessment of ovarian morphology is very useful element in early detection of ovarian neoplasm. Serum CA 125 concentration assay is not a test verifying malignancy. Using both methods at the same time we increase its sensitivity and negative predictive value.