فهرست نشریات علمی دسترسی آزاد ایران

Background & Objective: Ovarian cancer is a leading cause of gynecologic cancer mortality. Differentiating benign from malignant adnexal masses remains a key clinical challenge. This study was conducted with aim to evaluate a symptom-based score, CA125, and HE4, both individually and combined, for diagnosing ovarian cancer in Iranian women. Materials & Methods: This prospective analytical study was conducted in 2024 at Imam Hossein Hospital in Tehran. A total of 84 women with adnexal masses confirmed by MRI and scheduled for surgery were enrolled. Preoperative symptom scores and serum CA125 and HE4 were measured. Pathological diagnosis was the gold standard. Predictive power was assessed using logistic regression and diagnostic performance metrics (sensitivity, specificity, AUC). Data analysis was performed using Stata (version 17.) P<0.05 was considered statistically significant. Results: Of the 84 participants, 31(36.9%) had malignant tumors, 8(9.5%) borderline, and 45(53.6%) benign tumors. The malignant group was significantly older and had significantly higher levels of CA125, HE4, and symptom scores (P<0.001 for all biomarkers and score). In the combined multivariate model, only the symptom score remained an independent significant predictor (OR: 1.62, 95% CI: 1.24-2.13). The combined model achieved the highest discriminative ability (AUC: 0.971). The symptom score alone demonstrated the most balanced diagnostic profile with 83.87% sensitivity, 92.45% specificity, 90.74% NPV, and 89.29% accuracy. Conclusion: The symptom-based score demonstrated superior individual predictive performance for ovarian cancer compared to CA125 or HE4 alone. Although the three-marker combination yielded the highest discriminative power, the symptom score offered an optimal balance of high sensitivity and accuracy for practical clinical use.