The Worthiness of Ovary Symptom Index, Ca125 and Transvaginal Ultrasonography In Screening Malignancies of Adnexial Masses

INTRODUCTION: To evaluate the efficiency of Ovarian Cancer Symptom Index questionnaire by itself to define malignancy in patients with adnexial mass and to evaluate additional effect of CA125 and transvaginal ultrasonography on the index.
METHODS: 79 patients being prepared for operation because of adnexial mass in our clinic has been included in our study. Ovarian Cancer Symptom Index, CA125, transvaginal ultrasonography parameters were determined in preoperative term.Types, frequencies, severity and duration of symptoms were questionned and compared benign and malign cases. Parameters were compared with histopathology results after the surgery.
RESULTS: We did not find difference of Ovarin Cancer Syptom Index positivity between women with benign and malign adnexial mass (p>0.05). The sensitivity, specifity, positive predictive value, negative predictive value of Ovarin Cancer Syptom Index by itself were %68, %65, 0.41, 0.61 consequently. When we used The Symptom Index combined with CA125, we calculated sensitivity %73, spesifity %64, pozitive predictive value 0.32 and negative predictive value 0,76. The symptoms of abdominal pain, bloating, distension, eating disorders were significantly different between the groups. We found that Ultrasonographic Morphologic Scoring System by Sassone et al. was significant to differentiate malign and benign masses preoperatively.
DISCUSSION AND CONCLUSION: Contemporary Ovarian Cancer Symptom Index used in this study has not enough efficiency itself to differentiate malign and benign adnexial masses.It would be more useful to arrange a new symptom index for the diagnosis of ovarian cancer by using the symptoms which were significant to determine malignancy in our study.