RISK OF MALIGNANCY INDEX IN PREOPERATIVE EVALUATION OF ADNEXAL MASSES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 50
Abstract
BACKGROUND Ovarian tumour usually presents as adnexal mass but often it is difficult to differentiate between benign and malignant tumour. Several diagnostic modalities such as sonography and tumour markers have been evaluated in the past, but none have been established as an ultimate diagnostic tool individually. The development of a mathematical formula using a logistic model, incorporating menopausal status, the serum level of a glycoprotein called CA-125 and USG score has been described in the form of different malignancy indices. The purpose of this study was to evaluate the various risks of malignancy indices (RMI 4) in the preoperative evaluation of adnexal masses, especially to differentiate between benign and malignant masses. Another objective of the present study is statistical analysis of parameters like specificity, sensitivity, positive predictive value and negative predictive value. MATERIALS AND METHODS The prospective observational study of patients with adnexal masses detected during ultrasonography, who were scheduled for surgical exploration of adnexal mass and histopathological diagnosis, were included in the study. Histopathological examination was taken as gold standard to calculate the accuracy of RMI. The sensitivity, specificity and positive predictive value and negative predictive value of all the four RMI were calculated and data analysed. A total of 100 patients were included in the study over a period of 2 years. RESULTS Sensitivity of RMI-4 was 91.2%. Specificity of RMI was calculated to be 98.7%. Positive and negative predictive values of RMI were 98.1%, and 93.7%, respectively with ROC of 0.95. The best cut off value of RMI is 300. CONCLUSION Risk of Malignancy Index is a good diagnostic tool to differentiate between benign and malignant adnexal masses.
Authors and Affiliations
Augusti Mary Priyanka, Shubhada Suhas Jajoo
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