Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

Yavuzcan, Ali; Caglar, Mete; Ozgu, Emre; Ustun, Yusuf; Dilbaz, Serdar; Ozdemir, Ismail; Yildiz, Elif; Gungor, Tayfun; Kumru, Selahattin

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자료유형: 학술저널

저자정보: Yavuzcan, Ali (Department of Obstetrics and Gynaecology, Duzce University Faculty of Medicine) Caglar, Mete (Department of Obstetrics and Gynaecology, Duzce University Faculty of Medicine) Ozgu, Emre (Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Health Education and Research Hospital) Ustun, Yusuf (Department of Obstetrics and Gynaecology, Duzce University Faculty of Medicine) Dilbaz, Serdar (Department of Obstetrics and Gynaecology, Duzce University Faculty of Medicine) Ozdemir, Ismail (Department of Obstetrics and Gynaecology, Medicana International Istanbul Hospital) Yildiz, Elif (Department of Obstetrics and Gynaecology, Duzce University Faculty of Medicine) Gungor, Tayfun (Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Health Education and Research Hospital) Kumru, Selahattin (Department of Obstetrics and Gynaecology, Duzce University Faculty of Medicine)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제14권 제9호

발행연도: 2013.1

수록면: 5,455 - 5,459 (5page)

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Background: The risk of malignancy index (RMI) for the evaluation of adnexal masses is a sensitive tool in certain populations. The best cut off value for RMI 1, 2 and 3 is 200. The cut off value of RMI-4 to differentiate benign from malignant lesions is 450. Our aim was to evaluate the efficiency of four different malignancy indexes (RMI1-4) in a homogeneous population. Materials and Methods: We evaluated a total of 153 non-pregnant women with adnexal masses who did not have a history of malignancy and who were above 18 years of age. Results: A cut-off value of 250 for RMI-1 provided 95.9% inter-observer agreement, yielding 95.9% specificity, 93.5% negative predictive value, 75.0% sensitivity and 82.8% positive predictive value. A cut-off value of 250 for RMI-1 showed high performance in preoperative diagnosis of invasive malignant lesions than cut-off value of 200 in our population. A cut-off value of 350 for RMI-2 provided 94.5% inter-observed agreement, yielding 94.2% specificity, 93.4% negative predictive value, 75.0% sensitivity and 77.4% positive predictive value. RMI-2 showed the higher performance when the cut-off value was set at 350 in our population. A cut-off value of 250 provided 95.2% inter-observer agreement, yielding 95.0% specificity, 93.2% negative predictive value, 75.0% sensitivity, and 88.0% positive predictive value. RMI-3 showed the highest performance to diagnose malignant adnexal masses when the cut-off value was set at 250. In our study, RMI-4 showed similar statistical performance when the cut-off value was set at 400 [(Kappa: 0.684/p=0.000), yielding 93.8% inter-observer agreement, 93.4% specificity, 93.4% negative predictive value, 75.0% sensitivity, and 75.0% negative predictive value]. Conclusions: We showed successful utilization of RMIs in preoperative differentiation of benign from malignant masses. Many studies conducted in Asian and Pacific countries have reported different cut-off values as was the case in our study. We think that it is difficult to determine universally accepted cut-off values for RMIs for common use around the globe.

#Adnexal mass #ovarian cancer #risk of malignancy index

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