A RETROSPECTIVE ANALYSIS OF HISTOPATHOLOGICAL VARIATIONS IN ADNEXAL MASSES IN WOMEN OF REPRODUCTIVE AGE

Abstract

Background: It is not easily clear between benign and malignant adnexal masses in reproductive member of the women even with improvement in imaging and biomarkers. Purpose: The purpose was to define the histopathological range of the adnexal masses and analyze the connection between the chemical, sonographic, and clinical information and biomarker findings as well as to determine the independent predictors of malignancy. Approaches: We also used a retrospective cross-sectional study that focused on 452 women between the ages of 15 and 45 who received surgical excision of adnexal masses in January 2023 to December 2024. Specimens were typed according to the WHO guidelines. The amounts of preoperative ultrasound risk (IOTA strategy), the levels of serum CA-125, and HE4 were documented.

The analysis of descriptive statistics, the comparison test (x 2, t-test, ANOVA) and multivariable logistic regression were performed. Results: The prevalence of benign lesions was 80.8 percent (n=365), borderlines 7.1 percent (n=32) and malignant 12.2 percent (n=55). The most common in benign tumors were the serous cystadenomas. The rate of malignancy rose with age (10.3 percent compared with 16.0 percent in 15-24 years and 35-45 years, respectively). CA-125 and HE4 levels increased incrementally according to the malignancy status (p<0.001). Age as well as high-risk ultrasound, CA-125, and HE4 were independent predictors of malignancy (OR 1.08/year, 6.50, 1.20/10 U/ml, 1.15/50 pmol/L, respectively). Conclusions: The proposed combination of the age, the features of IOTA ultrasound, and biomarkers allows improving preoperative stratification of the risk of malignancy in reproductive-age women.