Publication:

Clinico-pathological correlation of ovarian tumors and tumor like lesions with role of CA125 and HE4 as biomarkers for discrimination of benign and malignant ovarian tumors

Background Ovarian tumors and tumor like lesions of ovary frequently form pelvic masses and are associated with hormonal manifestations. Clinically or surgically they can mimic malignancy but pathologically they could be benign tumors or tumor like lesions.

Methods The aim of present study is to do clinico-histopathological correlation of ovarian tumors and tumor like lesions of ovary and also evaluate the role of serum CA125, HE4 and calculate risk of ovarian malignancy algorithm (ROMA), for differentiation of benign and malignant ovarian tumors.233 cases of ovarian tumors and tumor like lesions were studied. Tumors were classified according to WHO classification. Clinical and histological findings were compiled on proforma and subjected to analysis.

Results In present study, out of total 233 cases, 41.2% were ovarian tumors and 58.8% tumor like lesions of ovary. Among tumor like lesions, follicular cyst was commonest lesion while among ovarian tumors, benign serous surface epithelial tumor was commonest. In patients with ovarian tumors, blood samples were collected, before and after the treatment for analysis of CA125, HE4 and ROMA.

Conclusions Serum values of CA125and HE4 as well as ROMA were highly elevated in women with malignant epithelial tumors as compared to women with benign lesions. Also, all the parameters i.e. HE4, CA125 and ROMA showed significant difference before and after surgery. Hence measuring serum HE4 and CA125 along with ROMA calculation may provide higher accuracy for detecting malignant epithelial ovarian tumor.