Utility of a Multi-Marker Panel with Ultrasound for Enhanced Classification of Adnexal Mass.

Simple Summary: Pre-surgical evaluation of a sonographically indeterminate adnexal mass is a complex process, and surgical referral relies on subjective evaluation of multiple clinical parameters. The requirement to mitigate malignancy risk means that the vast majority of post-surgical diagnoses are ultimately benign. Conversely, less than half of cancer patients receive a primary referral to an oncology expert, which can adversely affect their long-term outcome. In this study, we highlight the combination of transvaginal ultrasound with a multi-biomarker panel (MMP) to accurately identify and differentiate benign from all stages of malignant disease. The MMP index combined with transvaginal ultrasound (TVU) was superior to TVU plus CA125, particularly for the identification of early-stage malignancies. Incorporation of the MMP index into TVU-driven workflows can provide improved accuracy for the pre-surgical assessment of an adnexal mass, enabling greater confidence for subsequent patient triage. Pre-surgical clinical assessment of an adnexal mass typically relies on transvaginal ultrasound for comprehensive morphological assessment, with further support provided by biomarker measurements and clinical evaluation. Whilst effective for masses that are obviously benign or malignant, a large proportion of masses remain sonographically indeterminate at surgical referral. As a consequence, post-surgical diagnoses of benign disease can outnumber malignancies up to 9-fold, while less than 50% of cancer cases receive a primary referral to a gynecological oncology specialist. We recently described a blood biomarker signature (multi-marker panel—MMP) that differentiated patients with benign from malignant ovarian disease with high accuracy. In this study, we have examined the use of the MMP, both individually and in combination with transvaginal ultrasound, as an alternative tool to CA-125 for enhanced decision making in the pre-surgical referral process. [ABSTRACT FROM AUTHOR]