ADNEKSİYAL KİTLELERİN MALİGNİTE TANISINDA OVER KANSERİ SEMPTOM İNDEKSİ, CA 125 VE TRANSVAJİNAL ULTRASONOGRAFİNİN DEĞERLİLİĞİ

Year 2018, , 54 - 58, 05.03.2018

Özge Kaymaz Takmaz Ali Doğukan Anğın , Zehra Meltem Pirimoğlu

https://doi.org/10.16948/zktipb.346023

Abstract

Amaç:
Over Kanseri Semptom İndeksi’nin, tek başına malign adneksiyal kitlelerin
tanınmasındaki etkinliğinin;  CA125 ve transvajinal
ultrasonografi indeksinin tanı etkinliğine katkısının değerlendirilmesi. Gereç ve Yöntem: Çalışmamıza kliniğimizde
adneksiyal kitle nedeniyle operasyona hazırlanan 79 hasta dahil edildi.
Preoperatif dönemde CA125, transvajinal ultrasonografi ve Over Kanseri Semptom
İndeksi parametreleri değerlendirildi. Semptom tipleri, sıklığı, şiddeti ve
süresi sorgulanarak malign ve benign vakalar karşılaştırıldı. Operasyon
sonrasında kullanılan parametreler histopatolojik tanılarıyla karşılaştırıldı. Bulgular: Over kanseri Semptom İndeksi
pozitifliğini karşılaştırdığımızda malign ve benign adneksiyal kitlesi olan
kadınlarda anlamlı fark bulunmadı (p>0.05). Over Kanseri Semptom İndeksinin
tek başına sensitivitesi
%68,  spesifitesi %65, pozitif prediktif
değer 0.41, negatif prediktif değer 0.61 olarak saptandı. Çalışmamızda semptom indeks
pozitifliğinin evre değerlendirilmesinde de anlamlı olmadığını gözlemledik. Semptom indeks ve CA125  birlikte kullanıldığında ise sensitivite %73,
spesifite %64, pozitif prediktif değer 0.32, negatif prediktif değer 0.76
olarak hesaplandı. Semptom İndeksi sorgulamasında abdominal ağrı, abdominal
şişkinlik, distansiyon, yeme bozuklukları semptomları kendi başlarına gruplar
arasında anlamlı farklılıklar gösterdi. Sonuç:
Varolan Over Kanseri Semptom İndeksi, malign ve benign ayrımında tek başına
kullanılacak etkinliğe sahip değildir. Malignite tanısında anlamlı fark
gösteren indeksteki spesifik semptomların değerlendirmeye alınarak daha etkin
bir semptom indeksi oluşturulması over kanserli kadınların tanısında daha
yararlı olacaktır. 

Keywords

Over Kanseri, Semptom, İndeks, CA-125 antijeni

THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES

Abstract

Objective:
To evaluate the efficiency of Ovarian Cancer Symptom Index questionnaire by
itself to define malignancy in patients with adnexial mass and to evaluate
additional effect of   CA125 and
transvaginal ultrasonography on the index. Materials
and Methods: 79 patients being prepared for operation because of adnexial
mass in our clinic has been  included in
our study. Ovarian Cancer Symptom Index, CA125, transvaginal ultrasonography
parameters were determined in preoperative term. Types, frequencies, severity
and duration of symptoms were questionned and compared benign and malign cases.
Parameters were compared with histopathology results after the surgery. Results: We did not find difference of
Ovarin Cancer Syptom Index positivity between women with benign and malign
adnexial mass (p>0.05). The sensitivity, specifity, positive predictive
value, negative predictive value of Ovarin Cancer Syptom Index by itself were
%68, %65, 0.41, 0.61 consequently. When we used The Symptom Index combined with CA125, we
calculated sensitivity %73, spesifity %64, pozitive predictive value 0.32 and
negative predictive value 0,76. The symptoms of abdominal pain, bloating,
distension, eating disorders were significantly different between the groups. We
found that Ultrasonographic Morphologic Scoring System by Sassone et al. was
significant to differentiate malign and benign masses preoperatively. Conclusion: 
Contemporary Ovarian Cancer Symptom Index used in this study has not
enough efficiency itself to differentiate malign and benign adnexial masses.It
would be more useful to arrange a new symptom index for the diagnosis of
ovarian cancer by using the symptoms which were significant to determine
malignancy in our study. 

Keywords

ovarian cancer, sypmtom, index, CA-125 antigen

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