Erdodi Balazs, Szollosi Gergo Jozsef, Toth Zoltan, Krasznai Zoard Tibor, Jakab Attila
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
Doctoral School of Clinical Sciences, University of Debrecen, 4032 Debrecen, Hungary.
Cancers (Basel). 2025 Apr 20;17(8):1370. doi: 10.3390/cancers17081370.
: We aimed to determine the reliability of simple ultrasound (US) markers and CA-125 measurements in diagnosing peri- and postmenopausal ovarian masses. : The study was conducted in a retrospective setting. The preoperative imaging properties of peri- (PEM) and postmenopausal (POM) ovarian cysts were examined. Based on ultrasound findings, lesions were categorized as either (1) simple cysts, defined as unilocular, anechoic structures without solid components, or (2) complex cysts, characterized by any deviation from this morphology. Imaging characteristics, mass size, and demographic data were matched with histology and CA125 levels. : In total, 379 cystic structures (PEM: N = 195, average age: 45.6 years; range: 40-54 years, POM: N = 184, average age 61.2 years; range: 41-88 years) were analyzed. In the PEM group, there were 75 simple (Ø < 5 cm N = 32, Ø ≥ 5 cm N = 43) and 122 complex cysts (Ø < 5 cm N = 29, Ø ≥ 5 cm, N = 93), while in the POM group, 49 simple (Ø < 5 cm N = 9, Ø ≥ 5 cm N = 40) and 135 complex cysts (Ø < 5 cm N = 15, Ø ≥ 5 cm N = 120) were found. In the PEM group, malignancy was detected in complex cysts larger than 5 cm (N = 16, 17.58%). In the POM group, malignancy was present in 40 cases, and 3 of them proved to be smaller than 5 cm. The majority of cysts were functional (54.36%) in the PEM group. In the POM group, serous cysts were the most frequent (38.04%), followed by malignant (21.74%) and mucinous cysts (13.04%). CA125 was elevated in 66 of 217 cases (30.41%); only 23 were malignant (NPV: 0.95, PPV: 0.35). : Functional cysts are frequently found among perimenopausal ovarian cysts, with malignancy occurring exclusively in complex cysts exceeding 5 cm in diameter. However, complex cysts of any size carry a significant risk of malignancy in menopause, thus, surgery is recommended. Simple cysts can be followed by serial scans in both groups. CA-125 does not give added value to the detection of malignancy in perimenopausal patients. However, in postmenopausal complex morphology cysts larger than 5 cm, it may give added value to the suspicion of malignancy.
我们旨在确定简单超声（US）标志物和CA - 125测量在诊断围绝经期和绝经后卵巢肿块中的可靠性。
该研究采用回顾性研究方法。检查了围绝经期（PEM）和绝经后（POM）卵巢囊肿的术前影像学特征。根据超声检查结果，病变分为两类：（1）单纯囊肿，定义为单房、无回声结构且无实性成分；（2）复杂囊肿，其特征为与这种形态有任何偏差。将影像学特征、肿块大小和人口统计学数据与组织学及CA125水平进行匹配。
总共分析了379个囊性结构（PEM组：N = 195，平均年龄：45.6岁；范围：40 - 54岁，POM组：N = 184，平均年龄61.2岁；范围：41 - 88岁）。在PEM组中，有75个单纯囊肿（直径<5 cm的N = 32，直径≥5 cm的N = 43）和122个复杂囊肿（直径<5 cm的N = 29，直径≥5 cm的N = 93），而在POM组中，发现49个单纯囊肿（直径<5 cm的N = 9，直径≥5 cm的N = 40）和135个复杂囊肿（直径<5 cm的N = 15，直径≥5 cm的N = 120）。在PEM组中，直径大于5 cm的复杂囊肿中检测到恶性病变（N = 16，17.58%）。在POM组中，有40例为恶性病变，其中3例直径小于5 cm。PEM组中大多数囊肿为功能性囊肿（54.36%）。在POM组中，浆液性囊肿最为常见（38.04%），其次是恶性囊肿（21.74%）和黏液性囊肿（13.04%）。217例中有66例CA125升高（30.41%）；仅23例为恶性病变（阴性预测值：0.95，阳性预测值：0.35）。
功能性囊肿在围绝经期卵巢囊肿中很常见，恶性病变仅发生在直径超过5 cm的复杂囊肿中。然而，绝经后任何大小的复杂囊肿都有显著的恶性风险，因此建议手术治疗。两组中的单纯囊肿可通过连续扫描进行随访。CA - 125对围绝经期患者恶性病变的检测没有附加价值。然而，对于绝经后直径大于5 cm的复杂形态囊肿，它可能对恶性病变的怀疑有附加价值。
