INTERRELATION OF RISK INDICATORS OF MALIGNANCY INDEX AND MORPHOLOGICAL DETERMINANTS OF OVARIAN TUMOR
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*, https://orcid.org/0000-0002-6740-5286 Ibrahim A. Abdelazim2, https://orcid.org/0000-0002-7241-2835 Gulmira A. Zhurabekova3, https://orcid.org/0000-0002-2166-3095 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.
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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