Could see a big rise in requests because
of this. (good job it costs less than our tariff price I love PBR)
To the best of my knowledge the RCOG
guideline 34 (2003) is still very useful advice on this:
“Serum CA125 is well established
being raised in over 80% of ovarian cancer cases, if a cut-off of 30 u/ml is
used, the test has a sensitivity of 81% and specificity 75%. Ultrasound is also
well established, achieving a sensitivity of 89% and specificity of 73% when
using a morphology index”
They go on to recommend the calculation of
a risk of malignancy index
Table 1. Calculating the risk of
malignancy index (RMI); these are modifications of the original RMI using
modified scores
RMI = U x M x CA125
U = 0
(for ultrasound score of 0); U = 1
(for ultrasound score of 1); U = 3
(for ultrasound score of 2–5)
Ultrasound scans are scored
one point for each of the following characteristics: multilocular cyst;
evidence of solid areas;
evidence of metastases; presence of ascites; bilateral lesions.
M = 3
for all postmenopausal women dealt with by this guideline
CA125 is serum CA125 measurement in
u/ml
Table 2. An example of a protocol for
triaging women using the risk of malignancy index (RMI); data
from validation of RMI by Prys
Davies et al.16
Risk RMI Women
(%) Risk
of cancer (%)
Low <
25 40
<
3
Moderate 25–250 30 20
High > 250 30
75
Link http://www.rcog.org.uk/files/rcog-corp/GTG3411022011.pdf
Cheers John
From:
Clinical biochemistry discussion list [mailto:
Sent: 27 April 2011 00:39
To:
Subject: Simple blood test could
save hundreds from ovarian cancer - Health News, Health
Jonathan