The clinical significance of thrombocytosis in women presenting with a pelvic mass.

OBJECTIVES: We attempted to determine the clinical usefulness of a preoperative platelet count for predicting malignancy in patients presenting with a pelvic mass. Additionally, in patients in whom a preoperative serum CA 125 level was also determined, the clinical usefulness was compared. STUDY DESIGN: A retrospective review of charts of 241 patients presenting with a pelvic mass was carried out. The patients were then divided by pathologic diagnosis into group 1, benign disease (n = 102), and group 2, invasive (n = 121) or borderline (n = 18) malignancies. Thrombocytosis (platelet count greater than 400,000/microliters) was present in 16% (n = 16) of patients in group 1 and in 56% (n = 78) of patients in group 2 (p less than 0.0001). Of the 241 patients, 130 also had preoperative serum CA 125 levels measured. Elevated values of serum CA 125 (greater than 35 U/ml) occurred in 14% (n = 8) of group 1 and in 81% (n = 60) of group 2 (p less than 0.0001). The chi 2 test was used to analyze results of data. RESULTS: Statistically significant differences in preoperative platelet count and serum CA 125 values were found between group 1 and group 2 patients. The specificity and positive predictive value for thrombocytosis (84% and 83%) compared well with those for serum CA 125 (86% and 88%). The combined use of the tests resulted in specificity of 96% and positive predictive value of 95%. CONCLUSIONS: Preoperative platelet count is a test that is rapidly available and easily obtained. The test results may be of value in planning the original management of women presenting with a pelvic mass.