Clinical Analysis of CA125, CA72-4, and Risk of Malignancy Index in Distinguishing Benign and Malignant Ovarian Masses

Abstract

Objective: To analyse CA125, CA72-4, and risk of malignancy index in distinguishing benign and malignant ovarian masses.
Methods: This was a retrospective study of patients with ovarian mass. Patients were divided into four groups according to the pathology results: group A included follicular cyst, corpus luteum cyst, and ovarian cyst; group B comprised chocolate ovarian cyst; group C included benign ovarian tumour; and group D involved malignant ovarian tumour. Serum CA125 and CA72-4 were measured. Risk of malignancy index was calculated by CA125 value, menopause status, and ultrasound status.
Results: A total of 249 patients were included. The median values of CA125 (178.7 U/mL), CA72-4 (6.05 U/mL), and risk of malignancy index (873.2) in group D patients were significantly higher than the normal cut-off value as well as in the other three groups. In group B, the median CA125 was higher than the cut-off value (51.15 U/mL), but CA72-4 and risk of malignancy index were normal. The sensitivities of CA125, CA72-4, and risk of malignancy index were 80.95%, 52.38%, and 73.81%, respectively; respective values for specificity were 70.97%, 79.29%, and 95.41%; for positive predictive value were 35.78%, 31.88%, and 75.61%; and for negative predictive value were 95.06%, 90%, and 94.97%.
Conclusions: Serum CA125 had the highest sensitivity and risk of malignancy index had the highest specificity. Combination of the three factors, CA125, CA72-4, and risk of malignancy index could be used to differentiate benign ovarian mass from ovarian cancer and increased the specificity to 98%. The positivity rates of the three factors increased in line with the clinical status of ovarian cancer, and could be used to better evaluate the risk of ovarian cancer, especially epithelial ovarian cancer.