Asian Pacific Journal of Cancer Prevention

  • 제15권18호
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  • Pages.7793-7797
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  • 2014
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  • 1513-7368(pISSN)
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  • 2476-762X(eISSN)
아시아태평양암예방학회 (Asian Pacific Journal of Cancer Prevention)
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Role of a Risk of Malignancy Index in Clinical Approaches to Adnexal Masses

  • Simsek, Hakki Sencer (Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology) ;
  • Tokmak, Aytekin (Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology) ;
  • Ozgu, Emre (Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology) ;
  • Doganay, Melike (Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology) ;
  • Danisman, Nuri (Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology) ;
  • Erkaya, Salim (Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology) ;
  • Gungor, Tayfun (Hitit University, Department of Obstetrics and Gynecology)
  • 발행 : 2014.10.11
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초록

Objective: The aim of this study was to evaluate predictive role of risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Methods: This retrospective study was conducted with a total of 569 patients with adnexal masses/ovarian cysts managed surgically at our clinic between January 2006 and January 2012. Obtained data from patient files were age, gravidity, parity, menopause status, ultrasound findings and CA125 levels. For all patients ultrasound scans were performed. For the assessment of risk of malignancy index (RMI) Jacobs' model was used. Histopathologic results of all patients were recorded postoperatively. Malignancy status of the surgically removed adnexal mass was the gold standard. Results: Of the total masses, 245 (43.1%) were malignant, 316 (55.5%) were benign and 8 (1.4%) were borderline. The mean age of benign cases was lower than malign cases ($35.2{\pm}10.9$ versus $50.8{\pm}13.4$, p<0.001). Four hundred and five of them (71.2%) were in premenopausal period. Malignant tumors were more frequent in postmenopausal women (81% versus 29%, p<0.001). All ultrasound parameters of RMI were statistically significantly favorable for malignant masses. In our study ROC curve analysis for RMI provided maximum Youden index at level of 163.85. When we based on cutoff level for RMI as 163.85 sensitivity, specificity, PPV, NPV was calculated 74.7%, 96.2%, 94% and 82.6%, respectively. Conclusions: RMI was found to be a significant marker in preoperative evaluation and management of patients with an adnexal mass, and was useful for referring patients to tertiary care centers. Although utilization of RMI provides increased diagnostic accuracy in preoperative evaluation of patient with an adnexal mass, new diagnostic tools with higher sensitivity and specificity are needed to discriminate ovarian cancer from benign masses.

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참고문헌

  1. Andersen ES, Knudsen A, Rix P, Johansen B (2003). Risk of malignancy index in the preoperative evaluation of patients with adnexal masses. Gynecol Oncol, 90, 109-12. https://doi.org/10.1016/S0090-8258(03)00192-6
  2. Arun-Muthuvel V, Jaya V (2014). Pre-operative evaluation of ovarian tumors by risk of malignancy index, CA125 and ultrasound. Asian Pac J Cancer Prev, 15, 2929-32. https://doi.org/10.7314/APJCP.2014.15.6.2929
  3. Ashrafgangooei T, Rezaeezadeh M (2011). Risk of malignancy index in preoperative evaluation of pelvic masses. Asian Pac J Cancer Prev, 12, 1727-30.
  4. Bast RC Jr, Feeney M, Lazarus H, et al (1981). Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest, 68, 1331-7. https://doi.org/10.1172/JCI110380
  5. Bell R, Petticrew M, Sheldon T (1998). The performance of screening tests for ovarian cancer: results of a systematic review. Br J Obstet Gynaecol, 105, 1136-47. https://doi.org/10.1111/j.1471-0528.1998.tb09966.x
  6. Bian J, Li B, Kou XJ, Liu TZ, Ming L (2013). Clinical significance of combined detection of serum tumor markers in diagnosis of patients with ovarian cancer. Asian Pac J Cancer Prev, 14, 6241-3. https://doi.org/10.7314/APJCP.2013.14.11.6241
  7. Davies AP, Jacobs IJ (1993). The adnexal mass: benign or malignant? Evaluation of a risk of malignancy index. Br J Obstet Gynaecol, 100, 927-31. https://doi.org/10.1111/j.1471-0528.1993.tb15109.x
  8. Disaia J.P, Creasman W.T (2012). Clinical Gynecologic Oncology, 8th edition, Chapter. The Adnexal Mass, 212-13.
  9. Geomini P, Kruitwagen R, Bremer GL, et al (2009). The accuracy of risk scores in predicting ovarian malignancy: a systematic review. Obstet Gynecol, 113, 384-94. https://doi.org/10.1097/AOG.0b013e318195ad17
  10. Jacobs I, Oram D, Fairbanks J, et al (1990). A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynaecol, 97, 922-9. https://doi.org/10.1111/j.1471-0528.1990.tb02448.x
  11. Klug TL, Bast RC Jr, Niloff JM, et al (1984). Monoclonal antibody immunoradiometric assay for an antigenic determinant (CA125) associated with human epithelial ovarian carcinomas. Cancer Res, 44, 1048-53.
  12. Lin JY, Qin JB, Li XY, et al (2012). Diagnostic value of human epididymis protein 4 compared with mesothelin for ovarian cancer: a systematic review and meta-analysis. Asian Pac J Cancer Prev, 13, 5427-32. https://doi.org/10.7314/APJCP.2012.13.11.5427
  13. Ma S, Shen K, Lang J (2003). A risk of malignancy index in preoperative diagnosis of ovarian cancer. Chin Med J, 116, 396-9.
  14. Manjunath AP, Pratapkumar, Sujatha K, Vani R (2001). Comparison of three risk of malignancy indices in evaluation of pelvic masses. Gynecol Oncol, 81, 225-9. https://doi.org/10.1006/gyno.2001.6122
  15. Mathevet P, Delaloye JF (2013). Ovarian cancer screening in the general population. Rev Med Suisse, 9, 1943-4.
  16. Obeidat BR, Amarin ZO, Latimer JA, Crawford RA (2004). Risk of malignancy index in the preoperative evaluation of pelvic masses. Int J Gynaecol Obstet, 85, 255-8. https://doi.org/10.1016/j.ijgo.2003.10.009
  17. Sayasneh A, Wynants L, Preisler J, et al (2013). Multicentre external validation of IOTA prediction models and RMI by operators with varied training. Br J Cancer, 108, 2448-54. https://doi.org/10.1038/bjc.2013.224
  18. Su Z, Graybill WS, Zhu Y (2013). Detection and monitoring of ovarian cancer. Clin Chim Acta, 415, 341-5. https://doi.org/10.1016/j.cca.2012.10.058
  19. Terzic M, Dotlic J, Likic I, et al (2013). Risk of malignancy index validity assessment in premenopausal and postmenopausal women with adnexal tumors. Taiwan J Obstet Gynecol, 52, 253-7. https://doi.org/10.1016/j.tjog.2013.04.017
  20. Tingulstad S, Hagen B, Skjeldestad FE, et al (1999). The riskof-malignancy index to evaluate potential ovarian cancers in local hospitals. Obstet Gynecol, 93, 448-52. https://doi.org/10.1016/S0029-7844(98)00433-5
  21. Tongsong T, Wanapirak C, Neeyalavira V, et al (2009). E-flow doppler indices for prediction of benign and malignant ovarian tumors. Asian Pac J Cancer Prev, 10, 139-42.
  22. Wanapirak C, Srisupundit K, Tongsong T (2006). Sonographic morphology scores (SMS) for differentiation between benign and malignant adnexal masses. Asian Pac J Cancer Prev, 7, 407-10.
  23. Winarto H, Laihad BJ, Nuranna L (2014). Modification of cutoff values for HE4, CA125, the Risk of Malignancy Index, and the Risk of Malignancy Algorithm for ovarian cancer detection in Jakarta, Indonesia. Asian Pac J Cancer Prev, 15, 1949-53. https://doi.org/10.7314/APJCP.2014.15.5.1949
  24. Yamamoto Y, Yamada R, Oguri H, et al (2009). Comparison of four malignancy risk indices in the preoperative evaluation of patients with pelvic masses. Eur J Obstets Gynecol Reproductive Biology, 144, 163-7. https://doi.org/10.1016/j.ejogrb.2009.02.048
  25. Yavuzcan A, Caglar M, Ozgu E, et al (2013). Should cutoff values of the risk of malignancy index be changed for evaluation of adnexal masses in Asian and Pacific populations? Asian Pac J Cancer Prev, 14, 5455-9. https://doi.org/10.7314/APJCP.2013.14.9.5455

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  4. Predictive Value of Malignancy Risk Indices for Ovarian Masses in Premenopausal and Postmenopausal Women vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.2177
  5. A prospective study to evaluate the risk malignancy index and its diagnostic implication in patients with suspected ovarian mass vol.10, pp.1, 2017, https://doi.org/10.1186/s13048-017-0351-2