Background/Objectives: We aimed to determine the reliability of simple ultrasound (US) markers and CA-125 measurements in diagnosing peri- and postmenopausal ovarian masses.Methods: The study was conducted in a retrospective setting. The preoperative imaging properties of peri- (PEM) and postmenopausal (POM) ovarian cysts were examined. Based on ultrasound findings, lesions were categorized as either (1) simple cysts, defined as unilocular, anechoic structures without solid components, or (2) complex cysts, characterized by any deviation from this morphology. Imaging characteristics, mass size, and demographic data were matched with histology and CA125 levels.Results: In total, 379 cystic structures (PEM: N = 195, average age: 45.6 years; range: 40–54 years, POM: N = 184, average age 61.2 years; range: 41–88 years) were analyzed. In the PEM group, there were 75 simple (Ø < 5 cm N = 32, Ø ≥ 5 cm N = 43) and 122 complex cysts (Ø < 5 cm N = 29, Ø ≥ 5 cm, N = 93), while in the POM group, 49 simple (Ø < 5 cm N = 9, Ø ≥ 5 cm N = 40) and 135 complex cysts (Ø < 5 cm N = 15, Ø ≥ 5 cm N = 120) were found. In the PEM group, malignancy was detected in complex cysts larger than 5 cm (N = 16, 17.58%). In the POM group, malignancy was present in 40 cases, and 3 of them proved to be smaller than 5 cm. The majority of cysts were functional (54.36%) in the PEM group. In the POM group, serous cysts were the most frequent (38.04%), followed by malignant (21.74%) and mucinous cysts (13.04%). CA125 was elevated in 66 of 217 cases (30.41%); only 23 were malignant (NPV: 0.95, PPV: 0.35).Conclusions: Functional cysts are frequently found among perimenopausal ovarian cysts, with malignancy occurring exclusively in complex cysts exceeding 5 cm in diameter. However, complex cysts of any size carry a significant risk of malignancy in menopause, thus, surgery is recommended. Simple cysts can be followed by serial scans in both groups. CA-125 does not give added value to the detection of malignancy in perimenopausal patients. However, in postmenopausal complex morphology cysts larger than 5 cm, it may give added value to the suspicion of malignancy.
背景/目的：本研究旨在评估简易超声标记物及CA-125检测在诊断围绝经期与绝经后卵巢肿块中的可靠性。 方法：采用回顾性研究方法，分析围绝经期与绝经后卵巢囊肿的术前影像学特征。根据超声检查结果，将病灶分为两类：(1) 单纯性囊肿：定义为单房、无回声、无实性成分的结构；(2) 复杂性囊肿：定义为任何偏离上述形态学特征的囊肿。将影像学特征、肿块大小及人口统计学数据与组织病理学结果及CA125水平进行匹配分析。 结果：共分析379例囊性结构（围绝经期组：195例，平均年龄45.6岁，范围40-54岁；绝经后组：184例，平均年龄61.2岁，范围41-88岁）。围绝经期组中，单纯性囊肿75例（直径<5cm 32例，直径≥5cm 43例），复杂性囊肿122例（直径<5cm 29例，直径≥5cm 93例）；绝经后组中，单纯性囊肿49例（直径<5cm 9例，直径≥5cm 40例），复杂性囊肿135例（直径<5cm 15例，直径≥5cm 120例）。围绝经期组中，恶性肿瘤仅见于直径大于5cm的复杂性囊肿（16例，占该亚组17.58%）。绝经后组中，共发现40例恶性肿瘤，其中3例直径小于5cm。围绝经期组中功能性囊肿占比最高（54.36%）；绝经后组中浆液性囊肿最常见（38.04%），其次为恶性囊肿（21.74%）和黏液性囊肿（13.04%）。217例患者中66例CA125升高（30.41%），其中仅23例为恶性（阴性预测值：0.95，阳性预测值：0.35）。 结论：围绝经期卵巢囊肿以功能性囊肿多见，恶性肿瘤仅发生于直径超过5cm的复杂性囊肿。然而绝经后任何大小的复杂性囊肿均具有显著的恶性风险，建议手术治疗。两组单纯性囊肿均可通过系列超声随访监测。CA-125检测对围绝经期患者恶性肿瘤诊断无附加价值，但对绝经后直径大于5cm的复杂性囊肿，可增强对恶性病变的怀疑指数。
肿瘤(癌症)患者之家