Diagnostic performance of preoperative level of platelet count in women with ovarian masses.
E. Myriokefalitaki, N. Burbos, S. G. Crocker, E. P. Morris, J. J. Nieto, T. J. Duncan
AIM: Evaluate the predictive value of thrombocytosis (platelet count > 400 x 10^9) in discriminating between benign and malignant ovarian masses.
METHODS: This is a retrospective study performed in a gynaecological oncology centre in the United Kingdom between January 2007 and January 2010. 501 women with histological confirmed ovarian masses were included in the analysis. Details of ultrasound findings, serum CA 125 levels, size of the ovarian mass, preoperative platelet count and final histology were recorded.
RESULTS: 362 (72.3%) women were found to have benign masses, 103 (20.6%) women were diagnosed with ovarian malignancy and 36 (7.2%) borderline tumours. The mean diameter of the ovarian masses on ultrasonography was 9.77 cm (SD: 5.48 cm). The preoperative platelet count in women with ovarian cancer was higher than in women with benign ovarian mass (388.28x10^6 vs 299.03x10^6; p value < 0.001). We found a positive correlation (rho: 0.374) of thrombocytosis with ovarian cancer (p value < 0.001). The relative risk for ovarian cancer in the presence of preoperative thrombocytosis was 10.04. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of thrombocytosis in differentiating between benign and malignant ovarian masses were 39 %, 96.1%, 74.1% and 84.7% respectively.
CONCLUSIONS: The presence of a normal preoperative platelet count in women with ovarian masses is associated with a low risk of ovarian malignancy (specificity 96.1% and NPV 84.7%)
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