J Med Assoc Thai 2013; 96 (11):1395

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D-Dimer as a Tumor Marker in Pre-Operative Assessment of Adnexal Masses
Worasethsin P Mail, Narkwichean A

Objective: To determine the sensitivity, specificity, and predictive value of serum D-dimer testing in preoperative assessment of adnexal masses.

Material and Method: D-dimer levels were measured pre-operatively in 200 women diagnosed with adnexal masses who underwent surgical treatment at Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital between June 2007 and May 2008. The CA-125 level was also recorded.

Results: When using cut-off value at 500 ng/ml, D-dimer has 91.8% sensitivity, 71.9% specificity, 58.9% PPV, and 95.2% NPV of the tests in differentiating benign from malignant adnexal masses, compared with CA-125, which had 75.4%, 73.0%, 59.7%, and 84.8% respectively (cut-off 65 U/ml). Furthermore, the likelihood ratio to be negative of D-dimer test is high at 0.11. In patients with epithelial ovarian cancer, D-dimer is increased in 83% of early stage (stage 1) ovarian cancer while only 39% of early stage patients have CA-125 level above cut-off value.

Conclusion: D-dimer could be a useful test in pre-operative assessment of adnexal masses. In this study D-dimer seems to be better than CA-125 in differentiating benign from malignant adnexal tumors.

Keywords: D-dimer, Tumor marker, Adnexal masses, Ovarian tumor, Ovarian cancer

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