scholarly journals A Novel Model To Predict Endometriosis in Patients with Ovarian Cysts: A Retrospective Study.

Author(s):  
Junmiao Xiang ◽  
Wei Shen ◽  
Zongwen Liang ◽  
Qiong Zhang ◽  
Ping Duan

Abstract ObjectiveTo develop a model that uses hematological indexes and clinical characteristics to help estimate the probability of endometriosis in patients with ovarian cysts.MethodsA retrospective study was conducted on 2242 patients who underwent surgery for benign ovarian cysts from January 2008 to November 2016. Variables included in the model were serum tumor markers, blood routine test, age, BMI, reproductive history, history of hysteroscopy, menstrual episodes. Logistic regression was used to construct a predictive model for endometriosis, Receiver Operating Characteristic curves and the areas under the curve was used to verify the model’s validities. Ten-fold cross-validation was primarily used as an internal validation to evaluate the prediction accuracies of the model. Normalized mean square errors (NMSE) was obtained to compare the reliability of different models.Results978 (43.6%) patients with endometriosis were included in the strudy. Univariate analysis showed that age, BMI, delivery, dysmenorrhea, menstrual cycle, duration of menstrual flow, history of hysteroscopy, CA-125 and CA-19-9 (P < 0.001) are associated with endometriosis. The area under the receiver operating characteristic curve for the model with CA-125 alone was 0.888, with a sensitivity of 81.6% and specificity of 83.5%. After adjustment for other multiple covariates, including age, mature delivery, irregular menstruation, dysmenorrhea, menstrual period, history of hysteroscopy, CEA, CA-19-9, monocyte count, platelet count, the model obtained had an AUC of 0.916, with a sensitivity of 0.849 and specificity of 0.864.ConclusionsThe diagnostic prediction model can be used as a framework for potential improvement in diagnosis of endometriosis in patient with ovarian cyst.

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110610
Author(s):  
Bilan Li ◽  
Yueyao Shou ◽  
Haiyan Zhu

Objective Coagulation indexes may be useful survival biomarkers for cervical cancer. This study evaluated the ability of hemoglobin, red blood cells (RBCs), platelets, and D-dimer levels to predict post-hysterectomy survival outcomes in patients with stage IA1 to IIA2 cervical cancer. Methods In this retrospective study, coagulation-related indexes were compared between the anemia and non-anemia groups. Independent variables were analyzed by the Cox proportional hazards model. Survival was assessed by the Kaplan–Meier method with the log-rank test. Mortality predictions were evaluated by receiver operating characteristic curves. Results Among this study’s 1088 enrolled patients, 152 had anemia. The 10-year overall survival and recurrence-free survival rates were 90.8% and 86.5%, respectively. Hemoglobin, RBC, and the rate of abnormal platelet counts were significantly lower in the anemia group. Abnormal preoperative D-dimer was an independent factor for recurrence-free survival. Receiver operating characteristic curves showed that D-dimer had area under the curve of 0.734 (cut-off value: 0.685, sensitivity: 85.7%, and specificity: 64.0%). Hemoglobin and platelets had areas under the curves of 0.487 and 0.462, respectively. Conclusion Preoperative D-dimer was the most effective prognostic predictor for patients with cervical cancer. The prognosis of patients with cervical cancer was poorer if their D-dimer levels were >0.685 mg/L.


2009 ◽  
Vol 19 (9) ◽  
pp. 1535-1538 ◽  
Author(s):  
Signe Risum ◽  
Estrid Høgdall ◽  
Svend A. Engelholm ◽  
Eric Fung ◽  
Lee Lomas ◽  
...  

The objective of this prospective study was to evaluate CA-125 and a 7-marker panel as predictors of incomplete primary cytoreduction in patients with stage III/IV ovarian cancer (OC). From September 2004 to January 2008, serum from 201 patients referred to surgery for a pelvic tumor was analyzed for CA-125. In addition, serum was analyzed for 7 biomarkers using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. These biomarkers were combined into a single-valued ovarian-cancer-risk index (OvaRI). CA-125 and OvaRI were evaluated as predictors of cytoreduction in 75 stage III/IV patients using receiver operating characteristic curves.Complete primary cytoreduction (no macroscopic residual disease) was achieved in 31% (23/75) of the patients. The area under the receiver operating characteristic curve was 0.66 for CA-125 and 0.75 for OvaRI.The sensitivity and specificity of CA-125 for predicting incomplete cytoreduction were 71% (37/52) and 57% (13/23), respectively (P = 0.04). The sensitivity and specificity of OvaRI for predicting incomplete cytoreduction were 73% (38/52) and 70% (16/23), respectively (P = 0.001). In conclusion, CA-125 and an index of 7 biomarkers were found to be predictors of cytoreduction. However, future studies of biomarkers are anticipated to promote early diagnosis and provide prognostic information to guide treatment of OC patients. In addition, new biomarkers might also play a role in predicting outcome from primary surgery in OC patients.


2021 ◽  
Vol 81 (04) ◽  
pp. 354-364
Author(s):  
Linder Mariano Díaz Colmenarez ◽  
◽  
Belkys Carolina Zambrano Ramón ◽  
Daniel Alejandro Omaña Carrero ◽  
Manuel Santos Luque

Objective: To evaluate the usefulness of the platelet count and CA-125 in the discrimination between malignant and bening ovarian tumors at the Hospital Universitario de Los Andes, in a period of 5 years. Methods: Retrospective observational research. 419 patient medical stories coded as ovarian tumors were reviewed. The definitive pathology report was used as the gold standard test. Multiple statistical parameters of diagnostic performance were calculated from 2x2 tables and receiver operating characteristic (ROC) curves were plotted. Results: The mean platelet count: with invasive malignant ovarian tumors was 386/nl (CI 95 % 362-409), in benign tumors it 243/nl (CI 95 % 235-251) and in borderline tumors 237/nl (CI 95 % 198-276). Although the area under the curve receiver operating characteristic was higher for platelet count compared to CA125 levels (0.880 vs 0.790) this difference was not statistically significant. Among the mucinous tumors, the malignant ones did not present an elevated CA-125, but an elevated platelet count. Highest PPV of the platelet count was 95.6 % for > 350 / nl in postmenopausal women and 100 % for > 400/nl (p <0.001). Conclusion: The platelet count seems to have a similar utility to CA-125 to discriminate malignant from benign tumors and could improve diagnostic performance when both preoperative values are combined. Keywords: Platelets, Thrombocytosis, Ovary, Tumor, Cancer, CA-125, Diagnostic accuracy, Menopause.


2018 ◽  
Vol 11 (1) ◽  
pp. 18
Author(s):  
Aditiyono Aditiyono Aditiyono ◽  
Ali Budi Harsono ◽  
Herman Susanto

Keganasan ovarium memiliki angka morbiditas dan mortalitas yang tinggi karena umumnya ditemukan pada stadium lanjut. Penelitian ini bertujuan untuk mengetahui spesifitas dan sensitivitas CA 125 dan RMI2 dalam menentukan keganasan kista ovarium jenis epitel. Kadar CA 125 dan RM12 kemudian dilihat histopatologinya sebagai gold standard. Penelitian ini merupakan uji diagnostik, dilakukan di RSUP dr. Hasan Sadikin Bandung periode April s.d. September 2017. Sampel berjumlah 90 dengan 47 berkategori jinak dan 43 berkategori ganas berdasarkan hasil histopatologinya. Analisis data dilakukan secara univariat dan bivariat. Data kategorik diuji dengan uji chi-square atau uji Exact Fisher. Data numerik digunakan uji-t tidak berpasangan atau uji Mann Whitney. Sensitivitas dan spesifisitas data numerik disajikan dalam kurva Receiver Operating Characteristic (ROC). Berdasarkan kurva ROC maka diperoleh nilai area under curve (AUC). Hasil penelitian menunjukkan nilai median CA 125 kelompok ganas dibanding kelompok jinak (142,2 vs 61,030) bermakna secara statistik p = 0,000 (nilai p < 0,05), cut off point CA 125 adalah 99,9 U/mL dengan nilai sensitivitas 76,7% dan nilai spesifisitas 61,7%. Nilai median RMI2 kelompok ganas lebih besar dibandingkan dengan kelompok jinak (1676,8 vs 125) bermakna secara statistik p = 0,000 (nilai p < 0,05), cut off point RMI2 pada penelitian ini adalah 212,7 dengan sensitivitas 86% dan spesifisitas 70,2%. Nilai sensitivitas RMI2 dengan cut off point 200 adalah 88% dan spesifisitas 63,87%. Kesimpulan penelitian ini adalah CA125 adalah biomarker yang berguna untuk memprediksi keganasan ovarium, dengan nilai cut off point 99,9 ng/mL. Hal ini sangat berguna bila digunakan kombinasi CA 125 dengan hasil pemeriksaan Ultrasonografi (USG) dan status menopause atau dikenal dengan Risk Malignancy Index (RMI2 cut off point > 200 ) dengan sensitivitas 86%, spesifisitas 63,87% dan akurasi 74,4%.   The malignancy of ovarian cancer has high level of morbidity and mortality due to the fact that it is commonly found in advanced stage. This research is aimed to find out the specificity and sensitivity of C125 and RMI2 in determining the malignancy of epithelial ovarian cysts. The level of CA 125 and RM12 is then histopathology-measured as a gold standard. This research is a diagnostic study conducted in Hasan Sadikin Hospital Bandung during April until September 2017. Sample consists of 90 patients with 47 patients belong to low-malignancy group and 43 patients belong to high-malignancy group based on its histopathology. Data analysis is conducted by using univariate and bivariate. Categorical data is tested by using chi-square or Exact Fisher. Numeric data is tested by using unpaired t test or Mann Whitney. Sensitivity and specificity of numeric data is displayed in Receiver Operating Characteristic (ROC) curve. The ROC curve shows the value of area under curve (AUC). The result shows that the median of CA125 of the high-malignancy group compared to the low-malignancy group is (142,2 vs 61,030) which statistically means p = 0,000 (value p < 0,05), cut off point CA125 is 99,9 U/mL with sensitivity value 76,7% and specificity value 61,7%. The median of RMI2 of high-malignancy group is bigger compare to the low-malignancy group (1676,8 vs 125) which statistically means p = 0,000 (value p < 0,05), cut off point RMI2 of this research is 212,7 with sensitivity value 86% and specificity value 70,2%. The sensitivity value of RMI2 with cut off points 200 is 88% and the specificity value is 63,87%. This research concludes that CA125 is a useful biomarker to predict the malignancy of ovarian cancer with cut off point 99,9ng/mL. It will be very useful if it is combined with CA125 with Ultrasonography (USG) examination and menopause status or known as Risk Malignancy Index (RMI cut off point > 200) with sensitivity 86%, specificity 63,87% and accuracy 74,4%.


2020 ◽  
Author(s):  
Ling Pei ◽  
Huangmeng Xiao ◽  
Fenghua Lai ◽  
Zeting Li ◽  
Zhuyu Li ◽  
...  

Abstract Aims/Introduction: To analyze the incidence of early postpartum dyslipidemia and the potential predictors among women with history of gestational diabetes mellitus (GDM).Materials and Methods: This was a retrospective study. 589 women diagnosed with GDM were recruited and followed up at 6-12 weeks after delivery. The general demographic and metabolic data during pregnancy were collected. Participants were divided into the normal lipid group and dyslipidemia group according to the postpartum lipid level. Demographic and metabolic parameters were compared. Multivariate logistic regression was performed to analyze the potential predictors for the early postpartum dyslipidemia. Receiver operating characteristic (ROC) curve was conducted to determine the cut-off values.Results: 38.5% of the 589 women developed dyslipidemia in early postpartum and 60% of them had normal glucose metabolism. Delivery age, systolic blood pressure (SBP), glycated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C) were independent predictors of early postpartum dyslipidemia in women with history of GDM. The cut-offs of maternal age, SBP, HbA1c and LDL-C were 35 years, 5.1% and 3.56 mmol/L, respectively. LDL-C achieved a balanced mix of high sensitivity(63.9%)and specificity(69.2%)with highest area under the receiver operating characteristic curve(AUC) (0.696). When LDL-C was combined with age, SBP and HbA1c, the AUC reached to 0.733.Conclusions: Women with history of GDM should be screened lipid metabolism after delivery, particularly those with maternal age >35 years, SBP>123mmHg before labor, HbA1c>5.1%, or LDL-C>3.56mmol/L in the second trimester of pregnancy.


Author(s):  
Kathrin Dolle ◽  
Gerd Schulte-Körne ◽  
Nikolaus von Hofacker ◽  
Yonca Izat ◽  
Antje-Kathrin Allgaier

Fragestellung: Die vorliegende Studie untersucht die Übereinstimmung von strukturierten Kind- und Elterninterviews sowie dem klinischen Urteil bei der Diagnostik depressiver Episoden im Kindes- und Jugendalter. Zudem prüft sie, ob sich die Treffsicherheit und die optimalen Cut-off-Werte von Selbstbeurteilungsfragebögen in Referenz zu diesen verschiedenen Beurteilerperspektiven unterscheiden. Methodik: Mit 81 Kindern (9–12 Jahre) und 88 Jugendlichen (13–16 Jahre), die sich in kinder- und jugendpsychiatrischen Kliniken oder Praxen vorstellten, und ihren Eltern wurden strukturierte Kinder-DIPS-Interviews durchgeführt. Die Kinder füllten das Depressions-Inventar für Kinder und Jugendliche (DIKJ) aus, die Jugendlichen die Allgemeine Depressions-Skala in der Kurzform (ADS-K). Übereinstimmungen wurden mittels Kappa-Koeffizienten ermittelt. Optimale Cut-off-Werte, Sensitivität, Spezifität sowie positive und negative prädiktive Werte wurden anhand von Receiver operating characteristic (ROC) Kurven bestimmt. Ergebnisse: Die Interviews stimmten untereinander sowie mit dem klinischen Urteil niedrig bis mäßig überein. Depressive Episoden wurden häufiger nach klinischem Urteil als in den Interviews festgestellt. Cut-off-Werte und Validitätsmaße der Selbstbeurteilungsfragebögen variierten je nach Referenzstandard mit den schlechtesten Ergebnissen für das klinische Urteil. Schlussfolgerungen: Klinische Beurteiler könnten durch den Einsatz von strukturierten Interviews profitieren. Strategien für den Umgang mit diskrepanten Kind- und Elternangaben sollten empirisch geprüft und detailliert beschrieben werden.


1978 ◽  
Vol 17 (03) ◽  
pp. 157-161 ◽  
Author(s):  
F. T. De Dombal ◽  
Jane C. Horrocks

This paper uses simple receiver operating characteristic (ROC) curves (i) to study the effect of varying computer confidence of threshold levels and (ii) to evaluate clinical performance in the diagnosis of acute appendicitis. Over 1300 patients presenting to five centres with abdominal pain of short duration were studied in varying detail. Clinical and computer-aided diagnostic predictions were compared with the »final« diagnosis. From these studies it is concluded the simplistic setting of a 50/50 confidence threshold for the computer program is as »good« as any other. The proximity of a computer-aided system changed clinical behaviour patterns; a higher overall performance level was achieved and clinicians performance levels became associated with the »mildly conservative« end of the computers ROC curve. Prior forecasts of over-confidence or ultra-caution amongst clinicians using the computer-aided system have not been fulfilled.


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