Abstract

Background: Preoperative histologic confirmation of malignant ovarian tumors before chemotherapy is mandatory. There are few reports about combined use of tru cut and FNAC as methods of preoperative sampling of ovarian tumors.
Patients and methods: This is a prospective study conducted on 50 female patients presented with advanced ovarian tumors, during the period between 1/6/2011 and 31/10/2013. Trans-abdominal ultrasound guided tru cut biopsy and FNAC were performed for the patients at the same setting. The results were compared with the postoperative histopathology reports which considered as the gold standard.
Results: Of the 50 tru cut procedures; 46 cases (92%) revealed diagnostic tissue and 4 specimens were rendered non representative. The diagnostic accuracy of tru cut biopsy is 95.7% with sensitivity is 94.7% and specificity 100%. The diagnostic accuracy of FNAC is 95% with sensitivity is 94.3% and specificity 100%. The Positive predictive value is 100% for both techniques. The negative predictive value for tru cut and FNAC is 80% and 71.4% respectively. When tru cut was combined with FNAC the rate of inadequate samples have fallen to 0. The diagnostic accuracy of combined tru cut and FNAC was 95.5% with sensitivity is 94.9% and specificity 100%. The positive predictive value was 100% and the negative predictive value was 71.4%.
Conclusion: Both tru cut and FNAC are complementary to each other in achieving adequate samples for preoperative histologic diagnosis of ovarian tumors. Even if the diagnostic accuracy wasn't changed markedly, obtaining adequate samples can justify the beneficial combination of both techniques that will reduce the hazards and costs when a single technique has to be repeated to obtain sufficient tissues for diagnosis.

Keywords: Ovarian tumors; Tru cut; FNAC