Serum CA-125 is a good predictor of benign disease in patients with postmenopausal ovarian cysts

Abstract

Aim: To determine whether serum CA-125 levels, in addition to tumor size and ultrasonographic findings can help in differentiating benign ovarian cysts from malignant disease.

Methods: All postmenopausal women who had undergone explorative laporatomy for a preoperative diagnosis of an adnexal cyst between January 1999 and February 2006 were included if serum CA-125 levels were below 50 IU/ml.

Results: Ninety-three patients with ovarian cysts and serum CA-125 levels lower than 50 IU/ml were included. Seventy-five (80%) of the patients (53 unilocular, 22 multilocular) had ovarian cysts < 13 cm. Of 18 patients with ovarian cysts > 13 cm, seven had unilocular and 11 had multilocular cysts. All the patients (n = 77) with a serum CA-125 level < 35 IU/ml had benign histopathology regardless of the tumor size or ultrasonic features. Among 16 patients with CA-125 levels between 35 and 50 IU/ml, two with unilocular cysts > 13 cm and nine with multilocular cysts (3 < 13 cm, 6 > 13 cm) had borderline histopathology.

Conclusion: We concluded that when unilocular ovarian cyst size is < 13 cm and serum CA-125 levels are below 35 IU/ml in a postmenopausal woman, the possibility of a benign etiology is most likely.