Research Papers:

Circulating tumor cells in the differential diagnosis of adnexal masses

Dong Hoon Suh, Miseon Kim, Jin Young Choi, Jiyoon Bu, Yoon-Tae Kang, Byung Su Kwon, Banghyun Lee, Kidong Kim, Jae Hong No, Yong-Beom Kim _ and Young-Ho Cho

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Oncotarget. 2017; 8:77195-77206. https://doi.org/10.18632/oncotarget.20428

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Dong Hoon Suh1, Miseon Kim1, Jin Young Choi1, Jiyoon Bu2, Yoon-Tae Kang2, Byung Su Kwon3, Banghyun Lee4, Kidong Kim1, Jae Hong No1, Yong-Beom Kim1 and Young-Ho Cho2

1Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea

2Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea

3Department of Obstetrics and Gynecology, Pusan National University Hospital, Busan, Korea

4Department of Obstetrics and Gynecology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea

Correspondence to:

Yong-Beom Kim, email: [email protected]

Keywords: ovarian neoplasm, circulating tumor cell, preoperative period, differential diagnosis, early stage cancer

Received: January 02, 2017     Accepted: June 27, 2017     Published: August 24, 2017


The aim of this study was to evaluate circulating tumor cell (CTC) detection in the differential diagnosis of adnexal masses. A total of 87 preoperative women with an indeterminate adnexal mass were prospectively enrolled. Preoperative diagnostic modalities including CTC detection, risk of ovarian malignancy algorithm, risk of malignancy index, and computed tomography or magnetic resonance imaging were compared. Forty-three (49.4%) benign tumors, 13 (14.9%) borderline malignant masses, and 31 (35.7%) cancers were pathologically confirmed. Forty-nine (56.3%) cases were positive for CTCs: 19/43 (44.2%) benign, 10/10 (100%) early-stage, and 14/21 (66.7%) advanced-stage cancer. CTC detection had sensitivities of 77.4%, 100%, and 100% for benign vs. all stage cancer (n = 74), benign vs. stage I–II cancer (n = 53), and benign vs. stage I cancer (n = 49), respectively. CTC detection had a specificity of 55.8% across all comparisons. The sensitivities of the other modalities assayed were decreased in stage I–II cancer and stage I cancer vs. benign masses. Receiver operating characteristic curves showed that CTCs, of which the area under the curve was modest in all stage cancer (0.655), had the widest area under the curve among the evaluated modalities in stage I–II cancer and stage I cancer (0.768 for both). In conclusion, our study findings suggest that preoperative CTCs could have a substantial role in differentiating early stage cancer from benign tumors for adnexal masses.

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