Evaluation of ultrasonography markers and CA125 usefulness in the diagnosis of ovarian cysts

Abstract Objectives: The main aim of our study was to determine the features of the greatest importance in the prognosis of the functional nature of ovarian cysts, as well as the evaluation of the role of morphological index and CA125 in the diagnosis of functional ovarian cysts. Material and methods: 187 premenopausal women with ovarian tumor (between the ages of 13 and 52) were enrolled in the study. Each patient underwent transvaginal ultrasonography and the morphology of the tumor was assessed on the basis of morphological index. The level of CA125 was measured. The patients were divided into two groups: 1) patients with functional cyst, 2) patients with non-functional cyst. The study was performed between the years 2003-2006. Results: Functional ovarian cysts in ultrasonography included: unilocular with smooth internal wall, anechoic, without solid elements and with a thin wall of the structure (<3 mm). They were usually unilateral and ascites was rarely present. The morphological index (SM) achieved the highest accuracy (71.6%) at the cut-off level of ≥5. The area under ROC curve for SM was 0.834. The level of CA125 did not differ significantly between the analyzed groups. Conclusions: Tumors with 5 points or less in morphological index estimation may be safely observed during 2 or 3 menstruation cycles, as their spontaneous regression is anticipated. Assessment of CA125 concentration is a test with low clinical usefulness and marginal statistical significance.