Abstract
Objective: This research aimed to analyze sensitivity and specificity values of platelets, RMI and both combined as ovarian cancer diagnostic modality in Haji Adam Malik Hospital in 2016-2018.
 Methods: This is analytic research with a diagnostic test design on 204 patients who had been diagnosed with ovarian cancer and patients with ovary benign tumors which have been examined the value of full blood and the malignancy ratio index and ovarian mass that has been proven by the results of anatomic pathology at General Hospital Haji Adam Malik Medan in 2016-2018. The data is tabulated into 2x2 table and then calculated for each sensitivity, specificity, positive predictive value and negative predictive value. 
 Result: By using platelet cut-off value>450000 per mm3 in diagnosing ovarian cancer with sensitivity 55.44% and specificity 83.65% were obtained. IRK has a sensitivity 83.16% and specificity 76.92%. Platelet and IRK values provided the highest diagnostic value (specificity) compared to when they were each single which was 97.11% while the combination of platelet and IRK values had a sensitivity of 49.50%.
 Conclusion: Platelet and IRK values gives the highest diagnostic value (specificity) compared to when both are used, namely 97.11%.
Highlights
Around 192,000 new cases of ovarian cancer are found per year worldwide [1]
Based on table 1. it can be seen that the characteristics of ovarian cancer patients are more likely above 50 y old followed by age 36-50 y (40.6%) and the lowest with age below 20 y (2%), whereas in the benign tumor patient group are more likely with ages 20-35 y and ages 36-50 y respectively 37.5% and the lowest with ages under 20 y (3.8%)
This shows that ovarian cancer patients are more common in the older age group compared to ovarian tumor patients who are more likely to be found at a younger age
Summary
Significant platelet involvement in cancer growth and metastasis is a longstanding concept. This very large level of platelet production has the potential to increase through thrombocytosis as much as 20 times in response to various tumor and systemic gene factors. Correlations between high platelet counts and shorter survival rates are often found in lung, colon, breast, pancreatic, kidney, and gynecological cancers [3]. A several-fold increase in patient platelet count is a common finding in cancer. High preoperative platelet count is associated with early relapse of non-advanced epithelial ovarian cancer and colorectal cancer. Platelets affect the angiogenic and immunological processes in cancer, and protect tumor cells directly. Detection of platelet-derived growth factor, platelet factor 4 (PF-4) and platelet endothelial cell growth factor is recommended for the diagnosis of several cancers [4, 5]
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