Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/200817
Type: Artigo de periódico
Title: Symptoms, Ca125 And He4 For The Preoperative Prediction Of Ovarian Malignancy In Brazilian Women With Ovarian Masses.
Author: Pitta, Denise da Rocha
Sarian, Luis Otávio
Barreta, Amilcar
Campos, Elisabete Aparecida
Andrade, Liliana Lucci de Angelo
Fachini, Ana Maria Dias
Campbell, Leonardo Martins
Derchain, Sophie
Abstract: This manuscript evaluates whether specific symptoms, a symptom index (SI), CA125 and HE4 can help identify women with malignant tumors in the group of women with adnexal masses previously diagnosed with ultrasound. This was a cross-sectional study with data collection between January 2010 and January 2012. We invited 176 women with adnexal masses of suspected ovarian origin, attending the hospital of the Department of Obstetrics and Gynecology of the Unicamp School of Medicine. A control group of 150 healthy women was also enrolled. Symptoms were assessed with a questionnaire tested previously. Women with adnexal masses were interviewed before surgery to avoid recall bias. The Ward Agglomerative Method was used to define symptom clusters. Serum measurements of CA125 and HE4 were made. The Risk of Ovarian Malignancy Algorithm (ROMA) was calculated using standard formulae. Sixty women had ovarian cancer and 116 benign ovarian tumors. Six symptom clusters were formed and three specific symptoms (back pain, leg swelling and able to feel abdominal mass) did not agglomerate. A symptom index (SI) using clusters abdomen, pain and eating was formed. The sensitivity of the SI in discriminating women with malignant from those with benign ovarian tumors was 78.3%, with a specificity of 60.3%. Positive SI was more frequent in women with malignant than in women with benign tumors (OR 5.5; 95% CI 2.7 to 11.3). Elevated CA125 (OR 11.8; 95% CI 5.6 to 24.6) or HE4 (OR 7.6; 95% CI 3.7 to 15.6) or positive ROMA (OR 9.5; 95% CI 4.4 to 20.3) were found in women with malignant tumors compared with women with benign tumors. The AUC-ROC for CA125 was not different from that for HE4 or ROMA. The best specificity and negative predictive values were obtained using CA125 in women with negative SI. Women diagnosed with an adnexal mass could benefit from a short enquiry about presence, frequency and onset of six symptoms, and CA125 measurements. Primary care physicians can be thereby assisted in deciding as to whether or not reference the woman to often busy, congested specialized oncology centers.
Subject: Adult
Aged
Algorithms
Brazil
Ca-125 Antigen
Cross-sectional Studies
Female
Humans
Middle Aged
Neoplasm Staging
Ovarian Neoplasms
Ovary
Preoperative Period
Prognosis
Proteins
Sensitivity And Specificity
Tumor Markers, Biological
Rights: aberto
Identifier DOI: 10.1186/1471-2407-13-423
Address: http://www.ncbi.nlm.nih.gov/pubmed/24044637
Date Issue: 2013
Appears in Collections:Artigos e Materiais de Revistas Científicas - Unicamp

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