Diagnostic performance of serum CA-125 and ultrasonography in ovarian tumour differentiation

Early differentiation of benign versus malignant ovarian tumours is crucial for optimal management but remains challenging in many clinical settings. This analytical cross-sectional study at Rangpur Medical College Hospital, Bangladesh, included 62 surgically managed ovarian tumours (48 benign, 14 malignant) evaluated preoperatively by transabdominal ultrasonography and serum CA-125. Ultrasonography alone yielded a sensitivity of 57.42%, specificity 89.50%, PPV 61.84%, NPV 87.42% and accuracy 82.17%. Serum CA-125 showed better performance, with a sensitivity 71.42%, specificity 93.75%, PPV 76.92%, NPV 91.83% and accuracy 88.70%. Combining ultrasonography with CA-125 improved diagnostic accuracy to 91.32% (sensitivity 78.57%, specificity 93.75%), advancing preoperative triage by providing a simple, high-yield strategy for resource-limited settings.