ABSTRACT
To evaluate the performance of screening for ovarian malignancy by serum assay of inhibin and cancer antigen [CA-125] in patients with ultrasonographically diagnosed ovarian masses. Their predictive efficacy as tumour markers will also be assessed. Two-year observational, cross-section study of screening performance. Al-Azhar University Hospitals in Damietta and Cairo. 60-women with ovarian masses larger than 10cm were enrolled in this study. All patients were subjected to a complete medical history, clinical and ultrasonographic examinations. Laboratory assay of serum inhibin and CA-125 were performed before surgical procedure and repeated at 3-week and 6-month postoperative visits. All ovarian specimens were examined histopathologically. Mean concentrations of serum inhibin and CA-125. The mean concentrations of serum inhibin and CA-125 declined significantly in patients with benign ovarian masses at 3-week and 6-month follow-up visits in comparison with baseline concentrations [8.01 +/- 3.91 and 7.07 +/- 3.22 vs 14.30 +/- 5.42pg/mL; 24.60 +/- 5.19 and 24.30 +/- 10.72 vs 32.10 +/- 10.41U/mL, respectively]. [p+<0.05]. It was evident that the mean concentrations of serum inhibin and CA-125 were significantly higher in patients with malignant ovarian masses than in those with benign ovarian masses [p*<0.001]. In malignant ovarian mass group, there was a significant reduction of serum inhibin and CA-125 at 3-week and 6-month follow up visits in comparison with the baseline concentrations [21.60 +/- 2.35 and 21.60 +/- 3.07 vs 58.10 +/- 20.62pg/mL; 34.31 +/- 11.56 and 33.32 +/- 12.50 vs 69.81 +/- 27.72U/mL, respectively] [p+<0.05] The serum levels of inhibin and CA-125 were significantly higher in patients with endometrioid cysts than that in patients with other benign ovarian tumours [p<0.05]. In addition, the mean concentrations of serum inhibin and CA-125 were significantly higher in patients with dysgerminoma [82.70 +/- 21.20pg/mL and 63.52 +/- 15.90U/mL, respectively] compared with other pathological types of malignant ovarian tumours [p<0.05]. Considering the predictive efficacy of the studied tumour markers, elevated serum levels of inhibin and CA-125 could predict ovarian malignancy with a sensitivity of [82% vs 85%], specificity of [85% vs 78%], positive predictive value of [87% vs 82%], and negative predictive value of [79% vs 81%], respectively [p>0.05]. Screening modality of plasma inhibin assay has been proven to be efficacious as a tumour marker for ovarian malignancy. It has a predictive efficacy comparable to that of CA-125. Their use together could potentially improve sensitivity and specificity in screening for ovarian cancer