Ozcan H C, Balat O, Ugur M G, Kul S, Bozdag Z, Sucu S, Keklikcioglu I
Eur J Gynaecol Oncol. 2017;38(3):372-377.
To distinguish adnexal masses as benign and malignant, and to thereby identity the suitable surgical method for these masses, in premenopausal women, by retrospectively evaluating over a ten-year period, the diagnostic parameters, such as serum CA 125 and transvaginal ultrasonography (TVS), in combination with the presence of ascites in the abdomen.
The study was conducted with 255 premenopausal patients diagnosed with adnexal masses who had been admitted to the Gaziantep University Faculty of Medicine, Clinic of Gynecology and Obstetrics, between January 2003 and January 2013. Data collected from these patients included age, menopausal state, information regarding the presence of ascites, ultrasound findings, and serum CA 125 levels.
The mean age of the women included in the study was 32.79 ± 8.11 (range: 18-51) years. Based on the criteria mentioned above, 152 patients were treated by laparoscopy based on a strong suspicion of benign mass, while 103 patients were treated by laparotomy, based on a strong suspicion of malignant mass. CA 125 values did not have a significant effect on malignancy risk. Based on the TVS results, three malignant masses were reported postoperatively in the patient group strongly suspected to have benign masses, while five benign masses were reported postoperatively in the patient group strongly suspected to have malignant masses.An evaluation of the present diagnostic method showed that the TVS has a positive predictive value (PPV) of 94.19% in identifying malignant masses, and a negative predictive value (NPV) of 98.22% in identifying benign masses.
TVS and CA 125, along with an evaluation of menopausal status and ascites, can be an effective approach for diagnosing adnexal masses, and also for determining the proper surgical method to follow.
通过回顾性评估十年间绝经前女性血清CA 125和经阴道超声检查（TVS）等诊断参数，并结合腹部腹水情况，鉴别附件包块的良恶性，从而确定适合这些包块的手术方法。
该研究纳入了2003年1月至2013年1月期间在加济安泰普大学医学院妇产科门诊诊断为附件包块的255例绝经前患者。从这些患者收集的数据包括年龄、绝经状态、腹水情况、超声检查结果以及血清CA 125水平。
纳入研究的女性平均年龄为32.79±8.11（范围：18 - 51）岁。根据上述标准，152例患者因高度怀疑为良性包块而接受腹腔镜手术治疗，103例患者因高度怀疑为恶性包块而接受剖腹手术治疗。CA 125值对恶性风险没有显著影响。根据TVS结果，在高度怀疑为良性包块的患者组中，术后报告有3例恶性包块，而在高度怀疑为恶性包块的患者组中，术后报告有5例良性包块。对当前诊断方法的评估表明，TVS在识别恶性包块方面的阳性预测值（PPV）为94.19%，在识别良性包块方面的阴性预测值（NPV）为98.22%。
TVS、CA 125以及对绝经状态和腹水的评估，可成为诊断附件包块以及确定后续合适手术方法的有效途径。
