Can Preoperative Complete Blood Count Parameters and Tumor Markers Predict The Differential Diagnosis of Mucinous Ovarian Tumors?

INTRODUCTION: Mucinous ovarian tumors are typically large masses that cause preoperative and intraoperative evaluation challenges due to their size. Our study aims to assess the effectiveness of routinely studied preoperative complete blood count parameters and tumor markers in differentiating between benign, borderline, and malignant mucinous ovarian tumors.
METHODS: Patients who had surgery for a suspected adnexal mass and were diagnosed with a mucinous ovarian tumor between January 2019 and June 2023 were included in this study. The surgeries were performed at a gynecological oncology unit in a tertiary referral center. Cases that met the study criteria were categorized into three groups: benign, borderline, and malignant, based on their pathology results. We evaluated various parameters from the complete blood count (hemoglobin, hematocrit, leukocytes, neutrophils, lymphocytes, platelets, mean platelet volume), ratios of these parameters to each other (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio), tumor markers (Ca 125, Ca 19.9, CEA), and proportions of tumor markers to each other (Ca125/Ca19.9, Ca19.9/CEA).
RESULTS: The serum levels of Ca125, Ca19.9, CEA, and the Ca125/Ca19.9 ratio were significantly different between the groups (p<0.05). When using the cut-off values of Ca125>39 U/ml, Ca19.9>24.5 U/ml, CEA>4.9 ng/dl, and Ca125/Ca19.9 ratio ≤0.97, these markers showed sensitivities of 64.7%, 82.4%, 52.9%, and 64.7% respectively in distinguishing between benign and malignant mucinous ovarian tumors.
DISCUSSION AND CONCLUSION: Ca19.9 was the most sensitive marker in distinguishing between benign and malignant mucinous tumors, as well as borderline and malignant mucinous tumors.