Confirming the limited role of CA-125 for adnexal mass diagnosis

To prospectively evaluate the results of the CA-125 analyses performed on the IOTA (International Ovarian Tumor Analysis group) phase 1 data. Jump to… Methods Top of page Objectives Methods Results Conclusions Using the IOTA phase 1 data, logistic regression models with and without CA-125 as a predictor were developed to predict malignancy of ovarian tumors in pre- and postmenopausal women. These models were applied to the prospectively collected data from phase 2 (n = 1940). Their performance was evaluated using receiver operating characteristic (ROC) curves, area under the curve (AUC), and the sensitivity at 75% specificity (Sens75). Next, the performance of the expert operator's subjective impression (pattern recognition) was compared to CA-125 alone, and the median CA-125 level was computed for each histological endpoint. To this end, the data from IOTA phases 1, 1b, and 2 were used (n = 3513). Jump to… Results Top of page Objectives Methods Results Conclusions In premenopausal women, the logistic regression models with and without CA-125 had AUCs of 0.940 and 0.939, respectively. Sens75 levels were 94.2 and 95.9%. For postmenopausal women, the models with and without CA-125 had AUC values of 0.937 and 0.920, respectively, with Sens75 levels of 91.3 and 92.0%. The ROC curves for models with and without CA-125 were nearly identical in their top left part where sensitivity and specificity are high. Pattern recognition (sensitivity 92%, specificity 90%) clearly performed better than CA-125 alone. CA-125 levels were high in endometriomas (median = 20 U/ml) and abscesses (40 U/ml). Borderline stage I tumors had a median CA-125 level of 29 U/ml, rare primary invasive tumors of 52 U/ml. The highest CA-125 levels were obtained for primary invasive tumors of stage II–IV. Jump to… Conclusions Top of page Objectives Methods Results Conclusions The results confirmed our previous conclusions regarding the role of CA-125 in ovarian tumor diagnosis. This marker need not be used