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Titolo:
DIAGNOSTIC-VALUE OF PELVIC EXAMINATION, ULTRASOUND, AND SERUM CA-125 IN POSTMENOPAUSAL WOMEN WITH A PELVIC MASS - AN INTERNATIONAL MULTICENTER STUDY
Autore:
SCHUTTER EMJ; KENEMANS P; SOHN C; KRISTEN P; CROMBACH G; WESTERMANN R; MOBUS V; KAUFMANN M; CAFFIER H; SCHMIDTRHODE P; KREIENBERG R; VERSTRAETEN RA; CORNILLIE F;
Indirizzi:
FREE UNIV AMSTERDAM,ACAD HOSP,DEPT OBSTET & GYNAECOL,DE BOELELAAN 1117 1081 HV AMSTERDAM NETHERLANDS FREE UNIV AMSTERDAM,ACAD HOSP,DEPT OBSTET & GYNAECOL 1081 HV AMSTERDAM NETHERLANDS UNIV HEIDELBERG,FRAUENKLIN W-6900 HEIDELBERG GERMANY UNIV WURZBURG,FRAUENKLIN W-8700 WURZBURG GERMANY UNIV COLOGNE,FRAUENKLIN W-5000 COLOGNE GERMANY UNIV MARBURG,FRAUENKLIN W-3550 MARBURG GERMANY UNIV ULM,FRAUENKLIN W-7900 ULM GERMANY CENTOCOR DIAGNOST HEVERLEE BELGIUM
Titolo Testata:
Cancer
fascicolo: 4, volume: 74, anno: 1994,
pagine: 1398 - 1406
SICI:
0008-543X(1994)74:4<1398:DOPEUA>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
TISSUE POLYPEPTIDE ANTIGEN; PLACENTAL ALKALINE-PHOSPHATASE; EPITHELIAL OVARIAN-CANCER; TUMOR-ASSOCIATED ANTIGEN; CA-125 LEVELS; PREOPERATIVE EVALUATION; ADNEXAL MASSES; CARCINOEMBRYONIC ANTIGEN; MONOCLONAL-ANTIBODY; DIFFERENTIAL-DIAGNOSIS;
Keywords:
PELVIC MASS; DIFFERENTIAL DIAGNOSIS; PHYSICAL EXAMINATION; ULTRASONOGRAPHY; CA 125; POSTMENOPAUSAL PATIENTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
57
Recensione:
Indirizzi per estratti:
Citazione:
E.M.J. Schutter et al., "DIAGNOSTIC-VALUE OF PELVIC EXAMINATION, ULTRASOUND, AND SERUM CA-125 IN POSTMENOPAUSAL WOMEN WITH A PELVIC MASS - AN INTERNATIONAL MULTICENTER STUDY", Cancer, 74(4), 1994, pp. 1398-1406

Abstract

Background. In a prospective study, the differential diagnostic potential of pelvic examination, ultrasound, and serum CA 125 assay in postmenopausal patients presenting with a pelvic mass was assessed. Methods. A total of 228 patients were evaluated preoperatively in an international, multicenter, prospective study using a standard protocol for pelvic examination, transvaginal (occasionally additional abdominal) ultrasound, and serum CA 125 determination with a cut-off level of 35 U/ml. Results. Ninety-five malignant (41.7%) and 127 benign (55.7%) pelvic tumors were found in addition to 6 borderline ovarian tumors (2.6%)in the 228 patients. Seventy-two patients had ovarian carcinoma, 49 of whom were International Federation of Gynecology and Obstetrics Stage III or IV. Borderline tumors were excluded from the statistical calculations. The individual accuracy of pelvic examination, ultrasound, and serum CA 125 in discriminating between benign and malignant pelvic masses was approximately the same (76, 74, and 77%, respectively). Using logistic regression analysis, the power of pelvic examination appeared to be the most relevant factor (adjusted odds ratio, 9.2), followed by serum CA 125 (odds ratio, 5.6), and ultrasound (odds ratio, 4.9). Age appeared to be nonpredictive. No cancer was found in any patient in whom all three methods scored negative (n = 53; positive predictivevalue for malignancy = 0 and 95%; confidence interval, 0-7). Conclusions. The combined use of pelvic examination, ultrasound, and serum CA 125 leads to improved discrimination between malignant and benign pelvic masses, because malignancy can be excluded when all three examination methods are negative. A change to a more patient-tailored surgical approach could be considered in those cases.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 13:33:42