Efficacy of FNAC in the Diagnosis of Advanced Ovarian Malignancy

Worldwide, 6,044,000 women are diagnosed with cancer and 3,345,000 die from the disease each year. From 1975–2010, the age-standardized incidence rates for cancers in women have increased by 42%. Ovarian cancer accounts for 4% of all female cancers and 31% of cancers of the female genital tract, with more than 190,000 new cases diagnosed worldwide each year. Ovarian cancer is the fourth most common cause of death from malignancy in women This study assessed the diagnostic value of fine needle aspiration cytology (FNAC) in advanced ovarian malignant lesions and correlated FNAC result with Histopathologic findings of surgical specimen, and found out sensitivity, specificity, positive predictive value, negative predictive value of FNAC as a diagnostic test in malignant ovarian tumor. The study is conducted at Inpatient and outpatient department of Gynecological Oncology, Oncology, Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh for a Study period of one year. Cross sectional analytical type of study design was used Main outcome variables to be studied are the cytological report of FNAC and the histopathological report of specimens after debulking surgery. When combined with radiological assessment of the nature of the tumor, FNAC can serve as a highly efficient means of diagnosis of advanced ovarian neoplasms. In the study cases common clinical presentation were pain, distension of abdomen, tenderness, anorexia, nausea and early satiety. Majority had presented with lump size were < 100 cm2, most of the lump were in irregular margins, surfaces were nodular, consistency were solid and partly solid and partly cystic and. Mobility were restricted in majority cases and minority were freely mobile. Majority of serum CA 125 level were > 300 mI U/ml. Maximum FNAC findings of ovary was Adeno Carcinoma and maximum histological types was Papillary Serous Cyst adenocarcinoma and Serous Cyst adenocarcinoma. Performance of diagnostic test sensitivity of FNAC findings was 96.43%, specificity 100%, accuracy 96.67%, positive and negative predictive values were 100% and 66.67% respectively.