The Role of Serum C-Reactive Protein in Evaluation of Benign and Malignant Ovarian Tumors – An Observational study

Abstract

Background: Differentiating benign from malignant ovarian tumors preoperatively is critical for ensuring optimum surgical planning and patient outcomes. While CA-125 is widely used as a biomarker, its limited specificity highlights the need for supplementary markers such as C-reactive protein (CRP), which reflects systemic inflammation. 
Aim: To determine the sensitivity, specificity, and diagnostic accuracy of serum CRP and CA-125 individually and in combination for differentiating benign and malignant ovarian tumors. 
Materials and Methods: A hospital-based observational study was conducted on 50 women with adnexal masses. Preoperative CRP and CA-125 levels were measured; imaging findings were recorded. Histopathological examination (HPE) was the gold standard. Diagnostic accuracy indexes were calculated, and logistic regression identified independent predictors of malignancy. 
Results: Of 50 patients, 60% had benign tumors and 40% malignant. CRP ≥5 mg/L had sensitivity 75% and specificity 93.3%; CA-125 ≥35 IU/mL had sensitivity 80% and specificity 93.3%. Combined testing improved sensitivity to 90% and specificity to 96.7%. Ascites (90%), solid component (75%), bilateral masses (75%), and irregular margins were significantly associated with malignancy. Multivariate analysis identified CRP ≥5 mg/L, CA-125 ≥35 IU/mL, ascites, and solid component as independent predictors. 
Conclusion: CRP, especially when combined with CA-125, improves diagnostic accuracy in differentiating benign and malignant ovarian tumors and may be incorporated into preoperative evaluation strategies.