INTERRELATION OF RISK INDICATORS OF MALIGNANCY INDEX AND MORPHOLOGICAL DETERMINANTS OF OVARIAN TUMOR

Abstract

Introduction. Despite the favorable outcomes of benign ovarian neoplasms, there are still certain risks of their
malignancy. At the same time, the prognosis is mediated by the morphological type of benign neoplasms detected at the
early stages of maturation. An important starting point for a better prognosis and survival is the preoperative study of
malignancy rates and the choice of optimal treatment tactics.
Objective: To present the morphological features of ovarian neoplasms in close relationship with the risk index of
malignant neoplasms.
Materials and methods. The prospective study was conducted in the gynecology department of Aktobe hospital
(Kazakhstan) and Ahmadi hospital (Kuwait). Informed consent was obtained from patients to participate in the study. There
were included 264 women with ovarian tumors, that are divided into three age groups (reproductive, premenopausal, and
postmenopausal). RMI calculation and subsequent morphological examination of ovarian cyst samples with histopathological
(HP) confirmation were performed.
Statistically numeric variables are presented as mean ± standard deviation, categorical as numbers and percent (%). For
the analysis of quantitative and qualitative data, Student's t and chi-square (x2) tests were used, respectively. A receiver
operating characteristic (ROC) curve was used to determine the RMI value with sensitivity, specificity, PPV, and NPV and to
analyze the correlation coefficient between the RMI and the variables.
Results. There were identified about 26.5% of malignant and 73.48% of benign ovarian lesions were. The average age
of women with newly diagnosed ovarian neoplasms was 52.3 ± 9.1 and 41.5 ± 11.7 years, respectively (P = 0.9). The
incidence of malignant tumors was significantly higher in the premenopausal and postmenopausal groups compared with the
reproductive age group (P = 0.0008 and 0.0008, respectively). HP malignancy showed a higher RMI> 200, except for 12
false negatives. The ROC curve at a cut-off value > 247.5 in the three study groups had high sensitivity and specificity
(82.9% and 100%, respectively), PPV 100%, and NPV 98.1%. The area under the ROC curve (AUC) is 0.955.
Conclusion: In the study population, 96.7% of women with malignant ovarian cancer were correctly identified by the RMI
2 method with a threshold value of 200. The correspondence between the risk of malignancy according to RMI and
postoperative HP data is statistically significant. The area under the curves (AUC) ROC is 0.955 for RMI (P = <0.001).