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).
Akmaral S. Adilgereyeva1*, Ibrahim A. Abdelazim2, Gulmira A. Zhurabekova3, 1 West Kazakhstan Marat Ospanov Medical University, Department of Normal and Topographical Anatomy, Aktobe, Republic of Kazakhstan; 2 Ain Shams University, Department of Obstetrics and Gynecology, Cairo, Egypt, 3 Ahmadi hospital, Kuwait Oil Company (KOC), Kuwait; 4 Al- Farabi Kazakh National University, Department of fundamental Medicine, Almaty, Republic of Kazakhstan.
1. Aziz A.B., Najmi N. Is risk malignancy index a useful tool for predicting malignant ovarian masses in developing countries? // Obstet Gynecol Int 2015; (951256):1-5 2. Boujoual M., Hakimi I., Kouach J., Oukabli M., Moussaoui D.R., Dehayni M. Large twisted ovarian fibroma in menopausal women: a case report // Pan Afr Med J. 2015; 20: 322. doi:10.11604/pamj.2015.20.322.5998. 3. Dora S.K., Dandapat A.B., Pande B., Hota J.P. A prospective study to evaluate the risk malignancy index and its diagnostic implication in patients with suspected ovarian mass // J Ovarian Res. 2017; 10(1):55. doi: 10.1186/s13048-017-0351-2. [PubMed] 4. Hakansson F., Høgdall E.V.S., Nedergaard L., Lundvall L., Engelholm S.A., Pedersen A.T., Hartwell D., Høgdall C. from the Danish ’pelvic mass’ ovarian cancer study. Risk of malignancy index (RMI) used as a diagnostic tool in a tertiary centre for patients with a pelvic mass // Acta Obstet Gynecol Scand 2012; 91:496–502 5. Kroeger P.T., Drapkin R. Pathogenesis and heterogeneity of ovarian cancer // Curr Opin Obstet Gynecol. 2017 Feb; 29 (1): 26-34. doi: 10.1097/GCO.0000000000000340. PMID: 27898521; PMCID: PMC5201412. 6. Karimi-Zarchi M., Mojaver S.P., Rouhi M., Hekmatimoghaddam S.H., Moghaddam R.N., Yazdian-Anari P., Teimoori S. Diagnostic Value of the Risk of Malignancy Index (RMI) for Detection of Pelvic Malignancies Compared with Pathology // Electron Physician. 2015 Nov 20;7(7):1505-10. doi: 10.19082/1505. PMID: 26767105; PMCID: PMC4700897. 7. Mikhaleva L.M., Solomatina A.A., Argun M.Z., Khovanskaya T.N., Biryukov A.E. Morphofunctional features of the ovaries in benign small cystic tumors // Journal of Anatomy and Histopathology. 2019; 8(3): 46–52. doi: 10.18499/2225-7357-2019-8-3-46-52 8. Malli M., Vyas B., Gupta S., Desai H. A histological study of ovarian tumors in different age groups // Int J Med Sci Public Health 2014; 3: 338-341. 9. Mallika B., Chakravarthy V.K., Rao D.R. Histopathological study of ovarian tumours // J. Evolution Med. Dent. Sci. 2019; 8(09):551-554, DOI: 10.14260/jemds/2019/122 10. Qureshi N. et al. Histological Pattern of Ovarian Tumors in Reproductive Age Groups // Indo Am. J. P. Sci, 2017; 4(03): 587-592. 11. Rao S., Kapurubandara S., Anpalagan A. Elevated CA 125 in a case of leaking endometrioma // Case Rep Obstet Gynecol. 2018; 2018:2385048. 12. Javdekar R., Maitra N. Risk of malignancy index (RMI) in evaluation of adnexal mass. J Obstet Gynaecol India 2015;65:117-21 // The Journal of Obstetrics and Gynecology of India (March–April 2015) 65(2):117–121 DOI 10.1007/s13224-014-0609-1 13. Simsek H.S., Tokmak A., Ozgu E., Doganay M., Danisman N., Erkaya S., Gungor T. Role of a risk of malignancy index in clinical approaches to adnexal masses // Asian Pac J Cancer Prev. 2014;15(18):7793-7. doi: 10.7314/apjcp.2014.15.18.7793. PMID: 25292065. 14. Tingulstad S., Hagen B., Skjeldestad F.E., et al. Evaluation of risk of malignancy index based on serum CA 125, ultrasound findings and menopausal status in the preoperative diagnosis of pelvic masses // Br J Obstet Gynecol. 1996; 103:826 –31. 15. Terzić M. et al. Evaluation of the risk malignancy index diagnostic value in patientswith adnexal masses // Vojnosanit Pregl 2011; 68(7): 589–593. DOI: 10.2298/VSP1107589T 16. Veluswamy Arun-Muthuvel, Vijayaraghavan Jaya. Pre-Operative Evaluation of Ovarian Tumors by Risk of Malignancy Index, CA125 and Ultrasound // Asian Pac J Cancer Prev. 2014; 15(6), 2929-2932. DOI:
Количество просмотров: 46

Ключевые слова:

Библиографическая ссылка

Adilgereyeva A.S., Abdelazim I.A., Zhurabekova G.A. Interrelation of risk indicators of malignancy index and morphological determinants of ovarian tumor // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 5, pp. 31-39. doi 10.34689/SH.2021.23.5.004