Background Ovarian neoplasms represent a heterogeneous category of tumors with different histogenesis, clinical behavior, and prognosis, thus presenting a major challenge in gynecological oncology. The most popular biomarker in ovarian cancer is serum cancer antigen 125 (CA-125). Hence, the purpose of our study is to assess the diagnostic accuracy of serum CA-125 to differentiate between benign and malignant ovarian tumors using clinicopathological correlation in a tertiary care institution. Methods This is an observational study, retrospective in nature, carried out in the Department of Pathology at Rajendra Institute of Medical Sciences (RIMS), Ranchi, over 18 months. A total of 76 histopathologically confirmed ovarian tumor cases with available clinical, radiological, and serum CA-125 data were included. Preoperative serum CA-125 levels were measured using a cutoff value of 35 U/mL. Tumors were categorized as benign, borderline, or malignant based on histopathological criteria. Statistical analysis was performed using SPSS (IBM SPSS Statistics for Windows, IBM Corp., Version 27, Armonk, NY). Results Out of 76 ovarian tumors, 55 (72.4%) were benign, two (2.6%) were borderline, and 19 (25.0%) were malignant. Epithelial tumors (46, 60.5%) were the most common histological type. Serous cystadenoma (16, 21.1%) was the most frequent subtype. Elevated CA-125 levels were observed in all malignant tumors (19, 100%), while most benign tumors (49, 89.1%) showed normal levels. Serum CA-125 demonstrated sensitivity of 100%, specificity of 87.7%, positive predictive value of 73.1%, negative predictive value of 100%, and overall diagnostic accuracy of 90.7%. Conclusion The present study indicates that ovarian tumors are mainly benign, and most histological subtypes are epithelial tumors. Serum CA-125 demonstrated an excellent sensitivity in the detection of malignant tumors of the ovary, with all the malignant tumors portraying high levels of CA-125. These results show that CA-125 is a useful biomarker for identifying malignant ovarian tumors. However, its interpretation should be made in conjunction with clinical, radiological, and histopathological findings.
Choudhary et al. (Wed,) studied this question.