A. Gadducci et al., PREOPERATIVE EVALUATION OF D-DIMER AND CA-125 LEVELS IN DIFFERENTIATING BENIGN FROM MALIGNANT OVARIAN MASSES, Gynecologic oncology, 60(2), 1996, pp. 197-202
Plasma levels of D-dimer (DD) and CA 125 were measured preoperatively
in 121 patients with ovarian masses submitted to laparotomy. DD and CA
125 levels were higher in the 56 patients with epithelial ovarian can
cer than in the 65 patients with benign ovarian disease (P < 0.0001).
The logistic regression procedure showed that both DD assay (cutoff 41
6 ng/ml) and CA 125 assay (cutoff 65 U/ml) were significant predictive
variables for malignancy (P = 0.0001). The concordance between predic
ted probabilities and observed responses was 75.7% for DD, 72.1% for C
A 125, and 90.8% for DD and CA 125. It is worth noting that DD was inc
reased (>416 ng/ml) in 73% of FIGO stage I patients, whereas CA 125 wa
s above 65 U/ml in only 33.3%. Sensitivity, specificity, positive pred
ictive value, and negative predictive value of the tests in differenti
ating benign from malignant ovarian masses were as follows: 76.8, 93.8
, 91.5, and 82.4%, respectively, for CA 125; 94.6, 76.9, 77.9, and 94.
3%, respectively, for the combination CA 125 or DD; and 73.2, 100.0, 1
00.0, and 81.3%, respectively, for the combination CA 125 and DD. The
combination CA 125 and DD seems to be a useful diagnostic tool to diff
erentiate benign from malignant ovarian masses. Elevated preoperative
levels of both antigens are invariably associated with a postsurgical
diagnosis of epithelial ovarian cancer. (C) 1996 Academic Press, Inc.