Predictive Value of Inflammatory Markers, Ca-125 Measurement, and Malignancy Risk Index Calculations in the Diagnosis of Endometrioma

INTRODUCTION: Adnexal mass is a frequently encountered problem in gynecology practice. Although ultrasonography is our main tool in distinguishing endometrioma cases, there is a need for methods that will provide preoperative prediction, especially in rare cases. For this reason, we aimed to investigate the predictive value of CA-125 level, inflammatory markers, and malignancy index calculations in the diagnosis of endometrioma.
METHODS: In this study, 679 cases who were operated on, and diagnosed with an adnexal mass, at the Health Sciences University Haydarpaşa Numune Training and Research Hospital, Gynecology and Obstetrics Clinic, between 01.01.2010 and 30.06.2016, were retrospectively examined. The predictive value of CA-125, RMI, and inflammatory markers was investigated among these groups, which were divided into three groups: benign and malignant adnexal mass endometrioma patients.
RESULTS: In the comparison of the three groups, CA-125 value, malignancy risk index calculations, and some hematological markers were found to be statistically significantly higher. In the subgroup analysis for CA-125; It was found in the comparison of endometrioma and benign masses (p=0.000), in the comparison of benign and malignant masses (p=0.000), and the distinction between endometrioma and malignant masses (p=0.004).
In the subgroup analysis for inflammatory markers, the NLR value was found to be significantly different in malignant and benign cases (p=0.000). The neutrophil count was significantly different in malignant and benign cases (p=0.005).
DISCUSSION AND CONCLUSION: CA125 levels were found to be sensitive but not specific in the diagnosis of endometrioma. There is a need for studies on modeling in which new algorithms are developed in which TV-USG findings are combined with hematological markers.