Clinico-radiological and histopathological study of ovarian masses at a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231527Keywords:
Ovarian malignancy, Risk Malignancy Index, Ultrasonography, RMI, CA-125, PostmenopausalAbstract
Background: Counselling and rapid referral to a specialised facility might be improved with the use of a scoring system that could diagnose ovarian cancer. The relative simplicity of the Risk of Malignancy Index (RMI) scoring technique and the ease with which it may be applied make it a strong candidate to use as a primary diagnostic tool for individuals with pelvic masses.
Methods: Prospective observations study conducted on women diagnosed with ovarian mass by clinical examination and confirmed by ultrasonography, undergoing surgery at RL Jalappa Hospital, Kolar from January 2021 to December 2022. Histopathological report was considered as Primary outcome parameter. Age group, Parity, Menstrual history, Risk Malignancy Index, etc., were considered as explanatory parameters.
Results: A total of 40 subjects are included among which 22.50% are aged ≤40 years and 77.50% are aged >40 years. Using a cut off of 25, majority (88.2%) of those with malignancy had RMI≥25 and in benign histopathology report 56.5% had ≥25 RMI. Histopathology report, there was a statistically significant (p<0.05) difference in RMI values. The RMI had a sensitivity of 88.24% in predicting malignancy with specificity 43.48%, positive predictive value 53.57%, negative predictive value 83.33% with a total diagnostic accuracy of 62.50%.
Conclusions: Results from RMI and histopathology correlate positively. The results of this research show that RMI is a reliable and practicable method for assessing patients with pelvic masses at the commencement of therapy and identifying those who are good candidates for centralised surgical treatment.
Metrics
References
Sikdar K, Kumar P, Roychowdhary NN. A study of ovarian malignancy: A review of 149 cases. J Obstet Gynaecol India. 1981;30:478-480.
Grimes DA, Jones LB, Lopez LM, Schulz KF. Oral contraceptives for functional ovarian cysts. Cochrane Database Syst Rev. 2006;(4):CD006134.
Holt VL, Cushing-Haugen KL, Daling JR. Risk of Functional Ovarian Cyst: Effects of Smoking and Marijuana Use according to Body Mass Index. Am J Epidemiol. 2005;161(6):520-5.
Gupta N, Bisht D, Agarwal AK, Sharma VK. Retrospective and prospective study of ovarian tumours and tumour-like lesions. Indian J Pathol Microbiol. 2007;50(3):525-7.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA cancer J Clin. 2018;68(6):394-424.
Yoneda A, Lendorf ME, Couchman JR, Multhaupt HAB. Breast and ovarian cancers: a survey and possible roles for the cell surface heparansulfate proteoglycans. J HistochemCytochem. 2012;60(1):9-21.
Allemani C, Weir HK, Carreira H, Harewood R, Spika D, Wang X-S, et al. Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet. 2015;385(9972):977-1010.
Zhou L, Deng Y, Li N, Zheng Y, Tian T, Zhai Z, et al. Global, regional, and national burden of Hodgkin lymphoma from 1990 to 2017: estimates from the 2017 Global Burden of Disease study. J Hematol Oncol. 2019;12(1):107.
Puri S, Chadha V, Pandey A. Epidemiology of ovarian tumours in Northern India - A tertiary hospital based study. Indian J Com Fam Med. 2018;4(2):37-41.
Earle CC, Schrag D, Neville BA, Yabroff KR, Topor M, Fahey A, et al. Effect of surgeon specialty on processes of care and outcomes for ovarian cancer patients. J Nat Cancer Inst. 2006;98(3):172-80.
Hellström I, Raycraft J, Hayden-Ledbetter M, Ledbetter JA, Schummer M, McIntosh M, et al. The HE4 (WFDC2) protein is a biomarker for ovarian carcinoma. Cancer Res. 2003;63(13):3695-700.
Aktürk E, Karaca RE, Alanbay İ, Dede M, Karaşahin E, Yenen MC, et al. Comparison of four malignancy risk indices in the detection of malignant ovarian masses. J GynecolOncol. 2011;22(3):177.
Morgante G, Marca A, Ditto A, Leo V. Comparison of two malignancy risk indices based on serum CA125, ultrasound score and menopausal status in the diagnosis of ovarian masses. BJOG Int J ObstetrGynaecol. 1999;106(6):524-7.
Jacobs I, Oram D, Fairbanks J, Turner J, Frost C, Grudzinskas JG. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J ObstetGynaecol. 1990;97(10):922-9.
Davies AP, Jacobs I, Woolas R, Fish A, Oram D. The adnexal mass: benign or malignant? Evaluation of a risk of malignancy index. Br J ObstetGynaecol. 1993;100(10):927-31.
Ashrafgangooei T, Rezaeezadeh M. Risk of malignancy index in preoperative evaluation of pelvic masses. Asian Pac J Cancer Prev. 2011;12(7):1727-30.
BDSS Corp. coGuide Statistics Software, Version 1.0.3. Bangalore, India: BDSS corp; 2020. Available from: https://www.coguide.in/. Accessed on 09 January 2023.
Laul P, Miglani U, Srivstava A, Sood N, Miglani S. Correlation of clinical, biochemical and radiological characteristics with histopathology of ovarian masses: hospital based descriptive study. Int J ReprodContraceptObstet Gynecol. 2020;9(11):49-4455.
Kamath A, Satyarth S, Dave P. Diagnostic efficacy of risk of malignancy index in adnexal mass: a prospective study. N Indian J OBGYN. 2020;7(1):4-9.
Dora SK, Dandapat AB, Pande B, Hota JP. 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.
Rai R, Bhutia PC, Tshomo U. Clinicopathological profile of adnexal masses presenting to a tertiary-care hospital in Bhutan. South Asian J Cancer. 2019;8(3):168-72.
Priya F, Vanusha MH, Kirubamani NH. Clinical correlation of ovarian mass with ultrasound findings and histopathology report. Int J Reprod Contracept Obstet Gynecol. 2017;6(12):5230.
Baru L, Patnaik R, Singh KB. Clinico pathological study of ovarian neoplasms. Int J ReprodContraceptObstet Gynecol. 2017;6(8):3438.
Committee Opinion No. 716: The Role of the Obstetrician–Gynecologist in the Early Detection of Epithelial Ovarian Cancer in Women at Average Risk. Obstet Gynecol. 2017;130(3):e146-e149.
Javdekar R, Maitra N. Risk of Malignancy Index (RMI) in Evaluation of Adnexal Mass. J ObstetGynaecol India. 2015;65(2):117-21.
Al-Musalhi K, Al-Kindi M, Ramadhan F, Al-Rawahi T, Al-Hatali K, Mula-Abed W-A. Validity of Cancer Antigen-125 (CA-125) and Risk of Malignancy Index (RMI) in the Diagnosis of Ovarian Cancer. Oman Med J. 2015;30(6):428-34.