scholarly journals The Risk of Ovarian Malignancy Algorithm (ROMA) as a Predictor of Ovarian Tumor Malignancy

Author(s):  
Darlin Forbes ◽  
Irawan Sastradinata ◽  
Patiyus Agustiansyah ◽  
Theodorus Theodorus

Object: To assess the diagnostic value of Risk of Ovarian Malignancy Algorithm (ROMA) in predicting ovarian malignancy. Methods: Diagnostic test was performed at dr. Mohammad Hoesin Hospital Palembang during June 2016 to November 2016. Data were analized with SPSS version 21.0 and Med-calc statistic. Results: A total of 57 subjects were recruited in this study. Subjects were divided into two groups: the premenopausal and postmenopausal group. Analysis with ROC curve was performed, the ROMA optimal cut-off of ROMA was 23.7% and 48.15% in the premenopausal and the post-menopausal group, respectively. With the optimal cut-off, the sensitivity was 79.41% and specivicity was 75%, positive predictive value wa 73.07% and negative predictive value 83.77% with accuracy 76.92% in diagnosing ovarian malignancy. Compared to RMI-3, the sensitivity was 65.5% and specivicity was 85.7% with accuracy 75.44%. Conclusion: ROMA is not a reliable diagnostic tools of ovarian malignancy. Keywords: CA125, HE4, ovarian cancer, risk of ovarian malignancyalgorithm/ ROMA, risk of ovarian malignancy index/RMI

Author(s):  
Kintan Putri ◽  
Betty Agustina Tambunan ◽  
Willy Sandhika

Ovarian cancer is the fourth cancer with most incidence in Indonesian female with 10.238 cases in 20141. Tumor marker CA-125 is assosciated with ovarian cancer, importantly epithelial ovarian cancer. This study aims to find out diagnostic value (sensitivity, specificity, positive predictive value, negative predictive value) of CA-125 among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016. This study used analytic cross sectional method and was performed by evaluating medical records of patients suspected for ovarian malignancy in Dr. Soetomo General Hospital Surabaya in 2016. There were total 97 patients found fit for criteria of inclusion in this study. Tissue histopathological examination confirmed 66 patients have epithelial ovarian malignancy and 31 patients do not. Samples distributed using 35 U/ml as CA-125 upper limit, TP: 54.64%, FP: 19.59%, FN: 13.40%, dan TN: 12.37%. Diagnostic value obtained as follows: sensitivity 80.30%, spesificity 38.71%, positive predictive value 73.61%, negative predictive value 48%, and accuracy 67.01%. Tumor marker associated with ovarian cancer CA-125 has found high in sensitivity but low in specificity among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016.


Author(s):  
Liva Wijaya

Objective: To know the diagnostic value of a scoring system taken before surgery and frozen section in young-aged patients with suspected malignancy. Using that result, we can also investigate whether frozen section gives additional value to clinical scoring system. Method: This study is a diagnostic test. This study was carried out by accessing RSCM’s medical record from 2006-2011. From 437 patients suspected of ovarian malignancy, we included 157 patients due to age. Result: Diagnostic value of GP score are 77%, 49%, 61%, 68%, 63%, while RMI are 69%, 49%, 58%, 45%, 59%, (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy respectively). Diagnostic value of frozen section in patients with suspected malignancy using GP score >4 are 81.7%, 87.2%, 90.7%, 75.6%, 83%, while in patients with RMI 200 are 81%, 87%, 89%, 77%, 83% (sensitivity, spesificity, positive predictive value, negative predictive value, and accuracy respectively). Conclusion: Gatot Purwoto score and RMI have good diagnostic value in proving malignancy in young age. Its predictive value will be increased by frozen section. [Indones J Obstet Gynecol 2014; 3: 157-161] Keywords: frozen section, gatot purwoto score, ovarian malignancy, RMI, young age


1970 ◽  
Vol 36 (2) ◽  
pp. 68-73 ◽  
Author(s):  
Fawzia Hossain ◽  
Md Nazmul Karim ◽  
Shah Md Mahfuzur Rahman ◽  
Nazreen Khan ◽  
Maruf Siddiqui ◽  
...  

Purpose: Early detection of ovarian malignancy is of great clinical importance. The high mortality rate is due to the difficulties with the early detection of ovarian cancer. Current research attempted to assess the accuracy of Color Doppler Sonography and serum CA-125 level as diagnostic tool of ovarian tumor.Materials and Methods: In this cross-sectional study, 60 consecutive patients with ovarian tumor attending the Department of Obstetrics and Gynecology of BSMMU were recruited. Of the study participants 23.3% belong to 16-25 year age group, 20% belong to 26-35 years age group and 23.30% each were of 46-55 years and > 55 years age group. All the patients recruited were from in-patient department and had undergone surgery. Following excision, routine histopathology revealed 43.30% malignant (n=26) and 56.7% (n=34) benign ovarian lesion. Data were collected from the clinical history form and bimanual pelvic examination, serum CA 125 levels, estimation of Resistance index (RI), Pulsatility Index (PI), Novel Index by CDS and post-operative histo-pathological findings were then recorded. Sensitivity, specificity, accuracy, positive and negative predictive value of the diagnosis made by CDS, CA125, in the discrimination of the benign and malignant ovarian tumors was calculated. Using Receiver operative characteristics analysis the accuracy of RI, PI, CA 125 and Novel Index in the diagnosis of ovarian tumor (benign or malignant) were assessed.Results: With the Cut-off of <.5, Resistance Index is found to be capable of detecting 92% of malignant cases (sensitivity 91.7), and could detect 89% (specificity 88.9) of benign cases correctly which translates in to 90% accuracy in the diagnosis of ovarian tumor. Predictive values for positive (84.6) and negative (94.1) tests were also found to be quite high. Pulsatility index was found to be moderate accuracy (63.3%) with cutoff <1 for malignancy, however low predictive value for a positive test (38.5) questions its use. Both CA-125 and Novel Index showed similar level of sensitivity and specificity. Although Novel Index is derivative of CA125, Novel Index demonstrated better diagnostic accuracy and negative predictive value. The cutoff for CA 125 was mandated as 83.58. With the value the sensitivity is 76.9% and the specificity is 94.1%. RI is found to be more sensitive in detection of positive cases (Malignant) and CA125 is found to be more accurate in detection of negative cases (Benign). However a combination could be tried to make a better detection.Conclusion: Color Doppler ultra-sonography and CA125 excels in different tasks, the study concludes in favor of concurrent use of the methods for improving efficacy and thus early detection of ovarian malignancy. DOI: 10.3329/bmrcb.v36i2.6991Bangladesh Med Res Counc Bull 2010; 36: 68-73


Author(s):  
YOVITA V. ◽  
TALA MRZ ◽  
DINA S. ◽  
LUMBANRAJA S. N. ◽  
LUBIS D. L. ◽  
...  

Objective: This research aimed to analyze sensitivity and specificity values of platelets, RMI and both combined as ovarian cancer diagnostic modality in Haji Adam Malik Hospital in 2016-2018. Methods: This is analytic research with a diagnostic test design on 204 patients who had been diagnosed with ovarian cancer and patients with ovary benign tumors which have been examined the value of full blood and the malignancy ratio index and ovarian mass that has been proven by the results of anatomic pathology at General Hospital Haji Adam Malik Medan in 2016-2018. The data is tabulated into 2x2 table and then calculated for each sensitivity, specificity, positive predictive value and negative predictive value. Result: By using platelet cut-off value>450000 per mm3 in diagnosing ovarian cancer with sensitivity 55.44% and specificity 83.65% were obtained. IRK has a sensitivity 83.16% and specificity 76.92%. Platelet and IRK values ​​provided the highest diagnostic value (specificity) compared to when they were each single which was 97.11% while the combination of platelet and IRK values ​​had a sensitivity of 49.50%. Conclusion: Platelet and IRK values ​​gives the highest diagnostic value (specificity) compared to when both are used, namely 97.11%.


Author(s):  
Dr. Manisha ◽  
Dr. Ruchi Jindal

Background: The term "ovarian cancer" includes several different types of cancer that  arise from cells of the ovary, most commonly, tumors arise from the epithelium or lining cells of the ovary.  Ovarian cancer risk is positively associated with higher consumption of dietary cholesterol and eggs, and inversely associated with a higher intake of vegetables. High consumption of fats may increase circulating estrogen levels, thus increasing the possibility of cell damage and proliferation that is responsible for cancerous growth. Material & Methods: The present study was conducted at Geetanjali Medical College and Hospital, Udaipur (Rajasthan). Total  100 cases (females) attending the obstetrics and gynecology department for some gynecological and other problem  were selected for this study between the age of 40-60 years, who were attending cancer centre at GEETANJALI MEDICAL COLLEGE AND  HOSPITAL, Udaipur (Rajasthan).                GROUP I: - It consisted of healthy females control subjects (n=50) .By routine examination and tests, we ensured that all the subjects were healthy and there were no signs and symptoms or history of ovarian tumor and diseases GROUP II: - It consisted of ovarian cancer females subjects (n=50) with a history of ovarian tumor. Results:   Higher level of cholesterol, LDL, VLDL and low level of HDL are found in ovarian cancer patients. Conclusion: The present study we highlights the importance and role of serum lipid profile in diagnosis, prognosis and recurrence of the disease. The study shows that serum level of cholesterol, LDL, VLDL was elevated in  patients of ovarian cancer while low level of HDL are found in ovarian cancer patients. Key words: lipid profile, ovarian cancer.


Author(s):  
Youssriah Yahia Sabri ◽  
Ikram Hamed Mahmoud ◽  
Lamis Tarek El-Gendy ◽  
Mohamed Raafat Abd El-Mageed ◽  
Sally Fouad Tadros

Abstract Background There are many causes of pleural disease including variable benign and malignant etiologies. DWI is a non-enhanced functional MRI technique that allows qualitative and quantitative characterization of tissues based on their water molecules diffusivity. The aim of this study was to evaluate the diagnostic value of DWI-MRI in detection and characterization of pleural diseases and its capability in differentiating benign from malignant pleural lesions. Results Conventional MRI was able to discriminate benign from malignant lesions by using morphological features (contour and thickness) with sensitivity 89.29%, specificity 76%, positive predictive value 89%, negative predictive value 76.92%, and accuracy 85.37%. ADC value as a quantitative parameter of DWI found that ADC values of malignant pleural diseases were significantly lower than that of benign lesions (P < 0.001). Hence, we discovered that using ADC mean value of 1.68 × 10-3 mm2/s as a cutoff value can differentiate malignant from benign pleural diseases with sensitivity 89.3%, specificity 100%, positive predictive value 100%, negative predictive value 81.2%, and accuracy 92.68% (P < 0.001). Conclusion Although DWI-MRI is unable to differentiate between malignant and benign pleural effusion, its combined morphological and functional information provide valid non-invasive method to accurately characterize pleural soft tissue diseases differentiating benign from malignant lesions with higher specificity and accuracy than conventional MRI.


2019 ◽  
Vol 29 (2) ◽  
pp. 299-304 ◽  
Author(s):  
Arnold-Jan Kruse ◽  
Henk G ter Brugge ◽  
Harm H de Haan ◽  
Hugo W Van Eyndhoven ◽  
Hans W Nijman

ObjectiveVaginal hysterectomy with bilateral salpingo-oophorectomy may be an alternative strategy for patients with low-risk endometrial cancer and medical co-morbidities precluding laparoscopic or abdominal procedures. The current study evaluates the prevalence of co-existent ovarian malignancy in patients with endometrial cancer and the influence of bilateral salpingo-oophorectomy on survival outcomes in these patients.MethodsMedline and EMBASE were searched for studies published between January 1, 2000 and November 20, 2017 that investigated (1) the prevalence of co-existing ovarian malignancy (either metastases or primary synchronous ovarian cancer in women with endometrial cancer, and (2) the influence of bilateral salpingo-oophorectomy on recurrence and/or survival rates.ResultsOf the pre-menopausal and post-menopausal patients (n=6059), 373 were identified with metastases and 106 were identified with primary synchronous ovarian cancer. Of the post-menopausal patients (n=6016), 362 were identified with metastases and 44 were identified with primary synchronous ovarian cancer. Survival outcomes did not differ for pre-menopausal patients with endometrial cancer with and without bilateral salpingo-oophorectomy (5-year overall survival rates were 89–94.5% and 86–97.8%, respectively).ConclusionBilateral salpingo-oophorectomy during vaginal hysterectomy seems to have a limited impact on disease outcome in patients with endometrial cancer. These results support the view that vaginal hysterectomy alone or with bilateral salpingo-oophorectomy may be an option for patients with endometrial cancer who are not ideal surgical candidates.


2013 ◽  
Vol 20 (2) ◽  
pp. 251-262 ◽  
Author(s):  
Catherine M Olsen ◽  
Christina M Nagle ◽  
David C Whiteman ◽  
Roberta Ness ◽  
Celeste Leigh Pearce ◽  
...  

Whilst previous studies have reported that higher BMI increases a woman's risk of developing ovarian cancer, associations for the different histological subtypes have not been well defined. As the prevalence of obesity has increased dramatically, and classification of ovarian histology has improved in the last decade, we sought to examine the association in a pooled analysis of recent studies participating in the Ovarian Cancer Association Consortium. We evaluated the association between BMI (recent, maximum and in young adulthood) and ovarian cancer risk using original data from 15 case–control studies (13 548 cases and 17 913 controls). We combined study-specific adjusted odds ratios (ORs) using a random-effects model. We further examined the associations by histological subtype, menopausal status and post-menopausal hormone use. High BMI (all time-points) was associated with increased risk. This was most pronounced for borderline serous (recent BMI: pooled OR=1.24 per 5 kg/m2; 95% CI 1.18–1.30), invasive endometrioid (1.17; 1.11–1.23) and invasive mucinous (1.19; 1.06–1.32) tumours. There was no association with serous invasive cancer overall (0.98; 0.94–1.02), but increased risks for low-grade serous invasive tumours (1.13, 1.03–1.25) and in pre-menopausal women (1.11; 1.04–1.18). Among post-menopausal women, the associations did not differ between hormone replacement therapy users and non-users. Whilst obesity appears to increase risk of the less common histological subtypes of ovarian cancer, it does not increase risk of high-grade invasive serous cancers, and reducing BMI is therefore unlikely to prevent the majority of ovarian cancer deaths. Other modifiable factors must be identified to control this disease.


2016 ◽  
Vol 141 (2) ◽  
pp. 303-311 ◽  
Author(s):  
Cesare Romagnolo ◽  
Antonette E. Leon ◽  
Aline S.C. Fabricio ◽  
Martina Taborelli ◽  
Jerry Polesel ◽  
...  

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