Value of Ca 125 determination in preoperative diagnosis of pelvic masses

ABSTRACT

Preoperative determination of serum CA125 in patients with clinically diagnosed pelvic masses was done in 60 patients with an age range from 25 to 70 years. 20 [33.3%] of these cases had elevated CA125 Level [> 35U/ml], but of these 20 cases only 7 [35%] proved to be malignant. Of the 40 case with normal CA125 level only one case proved to be malignant and her age was above 50 years. No single case below 50 years and normal CA125 had a malignant mass, thus a normal CA125 level by itself is a more reliable predictor of benignity than an elevated level of malignancy and a normal CA125 level with an age below 50 years is a good predictor that the mass is benign. Elevated CA125 level with an age above 50 years raises the possibility [up to 75% in this study] for a pelvic mass to be a malignant one. Of the benign masses encountered in the study, elevated CA125 levels were found in 60% of cases of endometriosis, in 25% of inflammatory pelvic masses, in 18.2% of leiomyomata and lastly in 8.33% of cases in benign ovarian masses. The common occurrence of these non malignant conditions in younger age groups and the fact that malignancies could be associated with inflammatory reaction limit the value of an elevated CA125 in the diagnosis of malignancy in this age group