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Objective <p>To determine the diagnostic performance of serum tumor markers, IOTA models, and frozen section against final histopathology in ovarian tumors.</p> Methods <p>This cross-sectional study was conducted in the Department of Obstetrics and Gynecology at a tertiary care teaching hospital over one-year. Eighty clinico radiologically diagnosed cases of ovarian tumors were evaluated preoperatively using serum tumor markers (CA125, CA 19–9, CEA, AFP, <i>β</i>-hCG, LDH, inhibin B) and ultrasonography with IOTA assessment (Simple Rules and ADNEX model). All underwent surgery with intraoperative frozen section, followed by final histopathology as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, AUC, and <i>p</i> values were calculated for each modality.</p> Results <p>Among 80 cases, 63 were benign, 14 malignant, and the rest borderline. Epithelial tumors were the most common (65 cases), followed by germ cell (11) and sex cord-stromal tumors (4). Overall, tumor markers demonstrated the highest sensitivity (94.12%) but moderate specificity (68.25%) with 73.75% accuracy, with CA125 performing best among individual markers. The IOTA Simple Rules showed very high sensitivity (94.12%) but lower specificity (50.79%), whereas the ADNEX model offered a more balanced performance (82.35% sensitivity, 79.43% specificity, 80% accuracy). Frozen section achieved the highest diagnostic accuracy at 90%. All diagnostic modalities showed a significant association with the final histopathological diagnosis (<i>p</i> value &lt; 0.001).</p> Conclusion <p>Tumor markers provide subtype-specific diagnostic value, but the IOTA model offers superior preoperative performance. Intraoperative frozen section remains the most reliable and gold standard tool for real-time diagnosis and guiding surgical management.</p>

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Diagnostic Performance of Serum Tumor Markers, IOTA Models, and Frozen Section against Final Histopathology in Prediction of Malignancy in Ovarian Tumors: Which Method is Accurate??

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Riya Gupta,
  • Latika Sahu,
  • Y. M. Mala,
  • Rachita Garg,
  • Pallavi Pathak,
  • Reena Tomer

摘要

Objective

To determine the diagnostic performance of serum tumor markers, IOTA models, and frozen section against final histopathology in ovarian tumors.

Methods

This cross-sectional study was conducted in the Department of Obstetrics and Gynecology at a tertiary care teaching hospital over one-year. Eighty clinico radiologically diagnosed cases of ovarian tumors were evaluated preoperatively using serum tumor markers (CA125, CA 19–9, CEA, AFP, β-hCG, LDH, inhibin B) and ultrasonography with IOTA assessment (Simple Rules and ADNEX model). All underwent surgery with intraoperative frozen section, followed by final histopathology as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, AUC, and p values were calculated for each modality.

Results

Among 80 cases, 63 were benign, 14 malignant, and the rest borderline. Epithelial tumors were the most common (65 cases), followed by germ cell (11) and sex cord-stromal tumors (4). Overall, tumor markers demonstrated the highest sensitivity (94.12%) but moderate specificity (68.25%) with 73.75% accuracy, with CA125 performing best among individual markers. The IOTA Simple Rules showed very high sensitivity (94.12%) but lower specificity (50.79%), whereas the ADNEX model offered a more balanced performance (82.35% sensitivity, 79.43% specificity, 80% accuracy). Frozen section achieved the highest diagnostic accuracy at 90%. All diagnostic modalities showed a significant association with the final histopathological diagnosis (p value < 0.001).

Conclusion

Tumor markers provide subtype-specific diagnostic value, but the IOTA model offers superior preoperative performance. Intraoperative frozen section remains the most reliable and gold standard tool for real-time diagnosis and guiding surgical management.