CA 125 in the diagnosis of pelvic masses.

CA 125 was measured preoperatively in 184 female patients presenting with pelvic masses. Ovarian tumors were diagnosed in 151 cases (91 carcinomas, eight borderline, 52 benign) and non-ovarian tumors in 33 (19 malignant, 14 benign). The sensitivity of CA 125 in identifying the malignant and borderline ovarian tumors was 86%, the specificity 78%; and the positive and negative predictive values 82% and 83%, respectively. Increased antigen values (greater than 35 U/ml) were observed in 63% of the non-ovarian malignant tumors. Considering only the diagnosis of malignancy in pelvic masses (ovarian plus non-ovarian malignant tumors) the specificity improved to 89% and the positive predictive value to 93%; the sensitivity and the negative predictive value decreased to 82% and 74%, respectively. CA 125 in the normal range (less than or equal to 35 U/ml) was observed both in ovarian and non-ovarian carcinomas. Therefore, preoperative CA 125 values in the normal range should be interpreted with caution. However, increased preoperative CA 125 levels in patients with pelvic masses are highly suggestive of a malignant tumor and CA 125 should be an adjunct to the preoperative diagnostic armamentarium.