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Assessing CT imaging features combined with CEA and CA125 levels to identify endometriosis-associated ovarian cancer

  • Special Section: Ovarian Cancer
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To improve the diagnosis and identification of ovarian clear cell carcinoma (CCC) and ovarian endometrioid carcinoma (EC), we evaluated CT imaging findings and cut-off values for CEA and CA125.

Methods

The CT features and tumour markers (tumour size, location, morphology, composition, number of cysts, growth pattern of the mural nodules, mural nodule HWR, enhancement of the mural nodules, ascites, complications, CEA level, CA125 level) of 55 tumours in 52 patients with CCC, confirmed by surgery and pathology at the Yunnan Cancer Hospital from January 1, 2012 to December 30, 2018, were compared with those of 41 tumours in 36 patients with EC. All patients had a long history of endometriosis. Statistical analysis was performed using t test, chi-square test, Mann–Whitney U test, univariate analysis, multivariate logistic regression analysis and receiver-operating characteristic (ROC) curves.

Results

CCC and EC presented as large oval or irregular mixed cystic-solid masses in the pelvic region, with moderately delayed enhancement of the solid components. There was a statistically significant difference between the number of cysts, the growth pattern of the mural nodules, the presence/absence of ascites, and the levels of CEA and CA125 (P < 0.05). Most CCCs had unilocular cysts, mural nodules that were polypoid structures, and no ascites (46/55, 33/55, 42/55); most ECs had multilocular cysts and broad-based nodular structures and were ascites positive (28/41, 31/41, 21/41). The CEA positive rate was lower in the CCC group than in the EC group (2/52, 3.8% versus 11/36, 30.6%, P < 0.05), and the CA125 positive rate was high in both the CCC and EC groups (44/52, 84.6% versus EC = 35/36, 97.2%, P = 0.118). The ROC curves revealed that when the values of CEA and CA125 were higher than the cut-off values (CEA = 3.270 µg/L, CA125 = 589.400 kU/L), the diagnostic efficiency of CEA was 0.723, and the diagnostic specificity of CEA was as high as 0.903.

Conclusions

The number of cysts, growth pattern of the mural nodules, presence/absence of ascites, and levels of CEA and CA125 were useful factors for distinguishing CCC from EC; the best cut-off values of CEA and CA125 for distinguishing CCC from EC were 3.270 and 589.40, respectively. These findings may be helpful for correctly diagnosing and identifying CCC and EC.

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Data availability

Availability of data and material Please contact author for data requests.

Code availability

SPSS software 24.0.

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Funding

This work was supported by the Yunnan Applied Basic Research Projects-Joint Special Project [2019FE001(-246)].

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Authors and Affiliations

  1. Department of Radiology, Yunnan Cancer Hospital/The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Kunming, China

    Miaomiao Li, Jing Tan, Ya Zhang, Conghui Ai, Hongbo Wang, Huimei Zhang & Yan Jin

  2. Department of Radiology, The First people’s Hospital of Neijiang, No. 31 Jiaotong Road, Neijiang, China

    Yizhou Chen

Authors
  1. Miaomiao Li
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  2. Jing Tan
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  3. Ya Zhang
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  4. Conghui Ai
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  5. Hongbo Wang
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  7. Yan Jin
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  8. Yizhou Chen
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Contributions

ML contributed to the study conception and designed the study. Data acquisition was performed by ML and HZ. ML and YC performed the statistical analysis. All the authors contributed to the data analysis and interpretation. TJ, YZ, AH and YJ contributed equally to writing the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Miaomiao Li.

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The authors declare that they have no conflicts of interest and complied with ethical standards.

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Li, M., Tan, J., Zhang, Y. et al. Assessing CT imaging features combined with CEA and CA125 levels to identify endometriosis-associated ovarian cancer. Abdom Radiol 46, 2367–2375 (2021). https://doi.org/10.1007/s00261-020-02571-x

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  • DOI: https://doi.org/10.1007/s00261-020-02571-x

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