Volume 29, Issue 4, 2020
DOI: 10.24205/03276716.2020.891
Diagnostic Value of CT Combined with Serum CEA and CA-125 In Extra-Uterine Pelvic Leiomyomas and Ovarian Sex Cord-Stromal Tumor
Abstract
Uterus and ovary are the most common origin of benign and malignant pelvic tumors. Extrauterine leiomyoma and sex cord-stromal tumor have substantial overlap in clinical manifestation and imaging signs. Both ultrasonography and magnetic resonance imaging (MRI) have their intrinsic limits that are subject to enterocoel gas, spatial relationship between tumor and adjacent tissues, and dislocation of uterus. Our study investigated the value of computed tomography (CT) combined with serum CEA and CA-125 levels in the differential diagnosis of extrauterine leiomyoma and ovarian sex cord-stromal tumor. Clinical data, serum CEA and CA-125 levels of 43 patients with extrauterine leiomyoma and 36 patients with ovarian sex cord-stroma tumor were analyzed retrospectively, along with the plain and enhanced CT images. Compared with pathological ascertainment, our results showed that CEA, CA-125 levels, enhancement of mass, arterial blood supply, and presence of normal ovary, OVPS and ascites are independent factors for differentiation of extrauterine leiomyoma and sex-cord stroma tumors. A multivariate logistic regression model incorporated these variables rendered a diagnostic accuracy of 95.2% in extrauterine leiomyoma (sensitivity=93%, specificity=91.2%), and 90.8% in sex cord-stroma tumor (sensitivity=80.56%, specificity=86.2%). Our study highlighted the potential of combined use of CT signs with serum biomarker CEA and CA-125 in diagnosis of etrauterine leiomyoma and sex cord-stromal tumor which are intractably differentiated by ultrasonography and MRI.
Keywords
Extrauterine leiomyoma, Sex cord-stromal tumor of ovary, CA-125, Computed tomography, Miltivariate logistic model