Adneksiyal Kitlelerin Kriterleri, International Ovarian Tumor Analysis (IOTA) Malignite Risk İndeksi, Morfolojik İndeks ve Sadece Ultrasonografide Tümör Boyutu ile Değerlendirilmesi ve Bulguların Malignite ile İlişkisinin Karşılaştırılması

Year 2019, Volume: 16 Issue: 4, 196 - 200, 31.12.2019

Huri Güvey Melike Doğanay Sezen Bozkurt Köseoğlu Mengü Türker Tayfun Güngör

Abstract

Amaç: Bu çalışmanın amacı adneksiyal kitlesi olan premenapozal ve postmenapozal hastalarda preoperative dönemde malignite riskini değerlendirmek ve benign ve malign adneksiyal kitle ayırımını öngörmede tekniklerin etkilerini karşılaştırmaktır.
Materyal Metod: Ankara Dr Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Jinekoloji ve Onkoloji polikliniğine başvuran adneksiyal kitlesi olan, perimenapozal veya postmenapozal dönemde olan 160 hasta çalışmaya dahil edildi. Hastalar 4 gruba ayrılarak IOTA kriterleri, malignite risk indeksi, morfolojik indeks ve ultrasonografide tümör boyutu ile değerlendirildi. Bu prospektif değerlendirmelerin sonuçları postoperatif patoloji sonuçlarıyla karşılaştırıldı. Istatistiksel analizlerde modele dahil edilme olasılığı 0,05, çıkarılma olasılığı 0,10 olarak kabul edildi. Odds oranı (OR) lojistik regresyon analizinden elde edildi ve güven aralığı %95 olarak belirlendi. Gebeliği olan ve yapılan ultrasonografi tarihinden itibaren 3 ay içinde opere olmayan hastalar çalışmaya dahil edilmedi.
Bulgular: Preoperatif olarak malignite indekslerinden elde ettiğimiz sensitivite ve spesifite oranları sırasıyla IOTA’nın sensitivitesi %85.7, spesifitesi %80.8; malignite risk indeksin sensitivitesi %50, spesifitesi %94.1; morfolojik indeksin sensitivitesi %23.5, spesifitesi %94.1; ultrasonografide tümör boyutu değerlendirmesinin sensitivitesi %100, spesifitesi %31.3 olarak bulundu.
Sonuç: Sonuç olarak geniş popülasyonlar üzerinde yapılan çalışmalarla tanı doğruluğu kanıtlanmış ve bizim çalışmamızda da tanı doğruluğu (%85,7) en yüksek saptanan IOTA modelleri ile hastanın preoperatif malignite riski tahmin edilebilecek ve hastanın operasyonu bu doğrultuda planlanabilecektir.

Keywords

Adneksiyal kitle, malignite, skorlama sistemi, ultrason, menapoz

International Ovarian Tumor Analysis (IOTA) the Malignancy Risk Index, Morphologic Index, and the Ultrasonographically Determined Tumor Size in the Assessment of Adnexal Masses and the Correlation of the Relevance of the Results in the with Malignancy

Abstract

Aim: The aim of this study is to assess the malignancy risk in the pre-operative period and compare the effectiveness of the methods used in predicting the discrimination between benign and malignant adnexal masses in perimenopausal and postmenopausal patients presenting with an adnexal mass.
Material and methods: Presenting to Ankara Dr. Zekai Tahir Burak Women Health Educational and Research Hospital Gynecology and Oncology Outpatient Clinics, a total of 160 patients who were either in the perimenopausal or postmenopausal period and who were diagnosed with adnexal masses were included in the study. The patients were assigned into four respective groups and to be evaluated with IOTA (International Ovarian Tumor Analysis), malignancy risk index, morphological index, and the tumor size as determined by the ultrasound. The results of these prospective assessments were then compared with the postoperative histopathological results. In the statistical analysis, the probability of being included in the model was accepted to be 0.05, while, the probability of exclusion from the model was accepted to be 0.10. The Odds Ratios (OR) were derived from the logistic regression, and the level of confidence was determined to be 95%. Patients who hadn’t undergone the operation after 120 days from ultrasound and pregnants excluded from the study.

Results: Preoperatively yielded sensitivity and specificity rates of malignancy indexes for predicting a malignancy were found to be 85.7% and 80.8% for IOTA; 50% and 94.1% for the malignancy risk index; 23.5% and 94% for the morphological index; and 100% and 31.3% for the tumor size as determined by the ultrasound respectively.
Conclusion: Owing to the highest level of sensitivity of about 85.7% obtained by the IOTA models as proven also by large population-based studies, the risk of malignancy can be predicted and the surgical approaches can be planned accordingly in the pre-operative period.

Keywords

adnexal mass, malignancy, scoring system, ultrasound

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