Diagnostic Use of the Combination of CA72 ‐4 and Tumor Volume in Mucinous Ovarian Tumors
ABSTRACT
Objective
Mucinous ovarian cancer (MOC) is a rare epithelial ovarian cancer subtype with poor prognosis, particularly in advanced stages. Differentiating MOC from mucinous borderline ovarian tumor (MBT) remains clinically challenging, often leading to delayed or inadequate treatment. Accurate preoperative diagnosis is crucial for guiding surgical strategies and improving patient outcomes. This study evaluated preoperative clinical factors that can distinguish MOC from MBT.
Methods
We retrospectively analyzed 46 ovarian mucinous tumors diagnosed between 2017 and 2021, including 15 MOC and 31 MBT cases confirmed by histopathology. Patient age, tumor laterality, tumor size, tumor markers (CA125, CA19‐9, CA72‐4, CEA), and tumor volume were assessed. Tumor size was measured as the maximum magnetic resonance imaging diameter, whereas volume was calculated using three‐dimensional imaging. Statistical analyses included the Mann–Whitney U test and receiver operating characteristic curve analysis, with AUC as a measure of diagnostic accuracy.
Results
Among the tumor markers, CA72‐4 exhibited the highest diagnostic accuracy (area under the curve [AUC]: 0.834), with significantly higher levels in MOC than in MBT ( p < 0.001). Tumor size alone was an unreliable discriminator (AUC: 0.42). The tumor volume tended to be larger in MBT than in MOC (median: 2 362 878 cm 3 vs. 1 262 436 cm 3 ; p = 0.77). However, the combination of CA72‐4 and tumor volume improved the diagnostic performance (AUC: 0.875).
Conclusion
The combination of CA72‐4 levels and tumor volume enhances preoperative differentiation between MOC and MBT. This combined approach may optimize surgical planning and improve patient outcomes.