CA 125 measurement and ultrasonography in borderline tumors of the ovary

OBJECTIVES: Our goal was to perform an analysis of ultrasonographic charact eristics and CA 125 levels in ovarian tumors of borderline malignancy. STUDY DESIGN: We performed a retrospective analysis of CA 125 levels and ul trasonographic parameters in 91 patients with borderline tumors. RESULTS: Serous tumors of borderline malignancy were associated with elevat ed CA 125 levels in 75% of patients before surgery (mean, 156 IU/mL) compar ed with 30% of mucinous tumors (mean, 28 IU/mL; P=.004). CA 125 was elevate d in 35% of stage IA serous tumors (mean, 67 IU/mL) compared with 89% of tu mors with spread beyond the ovary (mean, 259 IU/mL; P=.001). Mucinous tumor s tended to be bigger (13.1 +/- 7 cm) on ultrasonography than serous tumors (9.3 +/- 6.2 cm, P=.016). Mucinous tumors were multilocular in half the pa tients and contained papillations in 40% of the patients. Serous tumors wer e multilocular in 30% of the patients but presented with solid or papillary patterns in 78% of the patients (P=.001). A resistance index of <0.4 was f ound in 36% of mucinous tumors and half the cases of serous tumors. In 13% of patients, ultrasonographic characteristics were compatible with a simple cyst only, including 1 patient with microinvasion and 1 patient with stage IIIB disease. Sensitivity of gray-scale ultrasonography was 87%, that of C A 125 measurement was 62%, and that of flow was 55%. At least 1 diagnostic test result was abnormal in 93% of patients, 2 were abnormal in 69% of pati ents, and all 3 were abnormal in 21% of patients. CONCLUSIONS: A high proportion of borderline tumors of the ovary, particula rly of the serous type, were associated with elevated CA 125 levels and abn ormal ultrasonographic characteristics, although some tumors presented as s imple cysts.