Association of raised CA 125/ CEA ratio and positive Ascitic fluid cytology with diagnosis of ovarian cancer in patients with adnexal mass.

Objective: To look for the association of raised CA 125/ CEA ratio and positive ascitic fluid cytology with the diagnosis of epithelial ovarian cancer in patients with an adnexal mass. Study Design: Comparative Cross-sectional study. Setting: Department of Oncology and Gynecology, Sheikh Zayed Hospital Rahimyarkhan. Period: September 2021 to February 2022. Material & Methods: A total of three hundred patients presenting with adnexal mass were recruited for the study. All patients underwent detailed evaluation, including CA 125 levels, CEA levels and ascitic fluid cytology. After complete staging workup, they underwent surgery and histopathological analysis of adnexal mass. A consultant histopathologist made the diagnosis of ovarian cancer. Association of various factors, including raised CA 125/ CEA ratio and positive ascitic fluid cytology with the diagnosis of ovarian cancer, was established. Results: Out of 350 patients of adnexal mass included in analysis, 273 (88%) were diagnosed with ovarian carcinoma, while 77 (22%) were not diagnosed with ovarian cancer after the surgery and had a diagnosis other than ovarian cancer. 179 (51.2%) patients were post-menopausal whereas 171 (48.8%) were pre-menopausal. It was revealed that raised CA-125/CEA ratio and positive ascitic fluid cytology had a statistically significant association with the diagnosis of ovarian carcinoma on histopathology (p-value<0.001). Conclusion: Most patients who presented with adnexal mass were diagnosed with ovarian carcinoma in our study. Raised CA 125/ CEA ratio and positive ascitic fluid cytology at baseline predicted a histopathological diagnosis of ovarian cancer in our study participants.