Role of Hypercoagulable State for Predictive Ovarian Malignancy in Women with a Pelvic Mass
Yanaranop, M.
Journal of the Medical Association of Thailand 100(Suppl 1): S148-S156
2017
ISSN/ISBN: 0125-2208 PMID: 29927556 Document Number: 17513
Ovarian cancer (OC) is an important malignancy in women worldwide and is associated with hypercoagulable To assess the performance of preoperative blood coagulability in discriminating between OCs and benign gynecologic diseases in women presenting with a pelvic mass, and to study the incidence of postoperative thromboembolic events. Preoperative coagulation tests (platelet count, prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen and D-dimer levels), and serum cancer antigen 125 (CA125) were investigated in women over 18 years old with clinically diagnosed pelvic or adnexal mass who underwent elective surgery at Rajavithi Hospital between January 2012 and December 2013. After a 9-week post-operation period, these patients were followed-up for VTE events. Of 196 women, 99 had OC and 97 had benign ovarian diseases. Platelet count, fibrinogen and D-dimer levels were significantly elevated in women with OC; however, only plasma fibrinogen level was a significant predictive factor for OC. Fibrinogen and CA125 displayed similar effectiveness (areas under receiver operating characteristic curve [ROC-AUCs], 76.0% vs. 77.7%) in OC prediction. A logistic model of combined fibrinogen and CA125 showed the best performance for OC prediction (ROC-AUC, 90.1%). Postoperatively, one deep vein thrombosis event in OC patients was found, while none appeared in patients with benign gynecologic diseases. Women with OC are significantly more associated with hypercoagulable state than those with benign gynecologic diseases. Plasma fibrinogen level was the significant predictive factor for OC, and only 1 post-operative VTE event occurred.