الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Ovarian cancer is a silent killer because symptoms were not thought to develop until the disease had advanced and the chance of cure or remission poor.
Angiogenesis is the stimulation of growth of a new vascular endothelial cells and development of new blood vessels. Tumor proliferation is severely limited by nutrient supply and waste removal from the tumor into the surrounding. Therefore, angiogenesis is a crucial factor in the progression of solid tumors and metastases.
At time of diagnosis, all patients are presented with complex mass (solid and cystic). Detection of the neovascularity by color Doppler ultrasound indexes (RI, PI, TAMV and dicrotic notch) of a complex mass detected by grey scale ultrasound.
In addition applying cancer antigen 125(CA125) as the most widely used biomarker for ovarian cancer, the concentration of CA125 are abnormal in about 80% of patient with advanced-stage disease, they are increased in only 40-50% of patients in the early-stage ovarian cancer. Upper limit for a normal serum level of CA125 is commonly 35IU\ml and above this level is suspicious of ovarian malignancy.
The aim of this study was to correlate grayscale & Doppler ultrasound criteria of ovarian mass in combination with serum CA125 (pre-operative) with histopathological diagnosis (postoperative).
The study includes 80 females recruited from El-Shatby Maternity University Hospital. Presented by complex ovarian mass diagnosed by grayscale ultrasound.
The patients were subjected to informed consent, history( age, family history and contraception used), complete physical examination (general, abdominal and vaginal), routine pre-operative investigations(complete blood picture, bleeding time, clotting time, PT, PTT, blood group, SCOT, SGPT, urea &creatinine) and CA125 was done using immune assay technique.
Color Doppler ultrasonography was done to measure RI, PI, TAMV and the absent or present of diacritic notch and finally laparotomy was done to all patients for surgical staging and excision of any suspicious intra-operative mass.
Histiopathological examination was done for the excised mass and it was the gold standard for the final diagnosis of the mass.
After the statistical analysis of the present study, the cutoff value of resistance index (RI) was 0.3, pulsatility index (PI) was 1, absent dicrotic notch shows high sensitivity, time average maximum velocity (TAMV) was the most useful indexes with cutoff value 11.5cm /sec with high sensitivity and positive predictive value and CA125 with cutoff value 35U/ml.