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Understanding the Value of Tumor Markers in Pediatric Ovarian Neoplasms. J Pediatr Surg 2020 Jan;55(1):122-125

Date

11/05/2019

Pubmed ID

31677824

Pubmed Central ID

PMC7181461

DOI

10.1016/j.jpedsurg.2019.09.062

Scopus ID

2-s2.0-85074475678 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

PURPOSE: The purpose of this study was to determine the diagnostic accuracy of tumor markers for malignancy in girls with ovarian neoplasms.

METHODS: A retrospective review of girls 2-21 years who presented for surgical management of an ovarian neoplasm across 10 children's hospitals between 2010 and 2016 was performed. Patients who had at least one concerning feature on imaging and had tumor marker testing were included in the study. Sensitivity, specificity, and negative and positive predictive values (PPV) of tumor markers were calculated.

RESULTS: Our cohort included 401 patients; 22.4% had a malignancy. Testing for tumor markers was inconsistent. AFP had high specificity (98%) and low sensitivity (42%) with a PPV of 86%. The sensitivity, specificity, and PPV of beta-hCG was 44%, 76%, and 32%, respectively. LDH had high sensitivity (95%) and Inhibin A and Inhibin B had high specificity (97% and 92%, respectively).

CONCLUSIONS: Tumor marker testing is helpful in preoperative risk stratification of ovarian neoplasms for malignancy. Given the variety of potential tumor types, no single marker provides enough reliability, and therefore a panel of tumor marker testing is recommended if there is concern for malignancy. Prospective studies may help further elucidate the predictive value of tumor markers in a pediatric ovarian neoplasm population.

TYPE OF STUDY: Retrospective Cohort Review.

LEVEL OF EVIDENCE: Level III.

Author List

Lawrence AE, Fallat ME, Hewitt G, Hertweck P, Onwuka A, Afrazi A, Bence C, Burns RC, Corkum KS, Dillon PA, Ehrlich PF, Fraser JD, Gonzalez DO, Grabowski JE, Kabre R, Lal DR, Landman MP, Leys CM, Mak GZ, Overman RE, Rademacher BL, Raiji MT, Sato TT, Scannell M, Sujka JA, Wright T, Minneci PC, Deans KJ, Aldrink JH, Midwest Pediatric Surgery Consortium

Authors

Christina Bence MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Dave Lal MD, MPH Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Biomarkers, Tumor
Child
Child, Preschool
Chorionic Gonadotropin, beta Subunit, Human
Female
Humans
Inhibins
L-Lactate Dehydrogenase
Ovarian Neoplasms
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Young Adult
alpha-Fetoproteins