Comparison of the prognostic values of inhibin and CA-125 as tumour markers for ovarian masses diagnosed by ultrasonography

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

Evaluation of ultrasonographic examination prediction of spontaneous first trimester abortion

This study was carried out on 445 patients in the first trimester of pregnancy. They had one or more risk factors for abortion. History and clinical examination were done and abdominal ultrasonographic examination was carried out on day 43 to 56, 57 to 70 and 71 to 84 of the estimated gestational age [EGA]. At the end of the first trimester, the results showed that the total incidence of abortion was 17.5%. The three ultrasonic examinations showed that the incidence of abortion was very high when the shape of gestational sac [GS] was irregular, followed by the dumbbell shape and when the average diameter of GS or crown-rump length [CRL] was shorter or longer than that of equal to EGA. Measurement of CRL on day 71 to 84 was accurate in prediction of first trimester abortion. It is concluded that ultrasound examination is accurate in predicting first trimester abortion. If EHM is not seen by day 71 to 84 of EGA, missed abortion should be considered. For patient at risk of abortion, ultrasound examination is recommended to be carried out as early in pregnancy as possible and to be repeated-within two weeks for three times