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ADNEKSİYAL KİTLELERİN MALİGNİTE TANISINDA OVER KANSERİ SEMPTOM İNDEKSİ, CA 125 VE TRANSVAJİNAL ULTRASONOGRAFİNİN DEĞERLİLİĞİ

Year 2018, Volume: 49 Issue: 1, 54 - 58, 05.03.2018
https://doi.org/10.16948/zktipb.346023

Abstract

Amaç:
Over Kanseri Semptom İndeksi’nin, tek başına malign adneksiyal kitlelerin
tanınmasındaki etkinliğinin;  CA125 ve transvajinal
ultrasonografi indeksinin tanı etkinliğine katkısının değerlendirilmesi. Gereç ve Yöntem: Çalışmamıza kliniğimizde
adneksiyal kitle nedeniyle operasyona hazırlanan 79 hasta dahil edildi.
Preoperatif dönemde CA125, transvajinal ultrasonografi ve Over Kanseri Semptom
İndeksi parametreleri değerlendirildi. Semptom tipleri, sıklığı, şiddeti ve
süresi sorgulanarak malign ve benign vakalar karşılaştırıldı. Operasyon
sonrasında kullanılan parametreler histopatolojik tanılarıyla karşılaştırıldı. Bulgular: Over kanseri Semptom İndeksi
pozitifliğini karşılaştırdığımızda malign ve benign adneksiyal kitlesi olan
kadınlarda anlamlı fark bulunmadı (p>0.05). Over Kanseri Semptom İndeksinin
tek başına
sensitivitesi
%68,  spesifitesi %65, pozitif prediktif
değer 0.41, negatif prediktif değer 0.61 olarak saptandı.
Çalışmamızda semptom indeks
pozitifliğinin evre değerlendirilmesinde de anlamlı olmadığını gözlemledik.
Semptom indeks ve CA125  birlikte kullanıldığında ise sensitivite %73,
spesifite %64, pozitif prediktif değer 0.32, negatif prediktif değer 0.76
olarak hesaplandı. Semptom İndeksi sorgulamasında abdominal ağrı, abdominal
şişkinlik, distansiyon, yeme bozuklukları semptomları kendi başlarına gruplar
arasında anlamlı farklılıklar gösterdi.
Sonuç:
Varolan Over Kanseri Semptom İndeksi, malign ve benign ayrımında tek başına
kullanılacak etkinliğe sahip değildir. Malignite tanısında anlamlı fark
gösteren indeksteki spesifik semptomların değerlendirmeye alınarak daha etkin
bir semptom indeksi oluşturulması over kanserli kadınların tanısında daha
yararlı olacaktır. 

References

  • 1) Landis SH, Murray T, Bolden S, Wingo PA. Cancer Statistics. Cancer J Clin 1999;49:8-31.
  • 2) Tortolero LG, Mitchell MF. The epidemiology of ovarian cancer. J Cell Biochem Suppl 1995;23:200-207.
  • 3) Kılıç D, Kaya İ, Kamaş A. T.C. Sağlık Bakanlığı. Sağlık İstatistikleri 2002; 2003;653:97.
  • 4) Karlon BY, Plan LD. The current status of ultrasound and color doppler imaging in screening for ovarion cancer. Gynaecol Oncol 1994;55:28-33.
  • 5) Sassone AM, Timor-Tritsch IE, Artner A, Westhoff C, Warren WB. Transvaginal sonographic characterization of ovarian disease: Evaluation of a new scoring system to predict ovarian malignancy. Obstet Gynecol 1991;78:70-6.
  • 6) Piver MS, Baker TR, Piedmonte M, Sandecki AM. Epidemiology and etiology of ovarian cancer. Semin Oncol 1991;18:177-85.
  • 7) Osmers RG, Osmers M, von Maydell B, Wagner B., Kuhn W. Preoperavite evaluation of ovarian tumors in the premenopouse by transvaginosonography. Am J Obstet Gynecol 1996;175(2):428-34.
  • 8) Goldstein SR, Subramanyam B, Synder JR, Beller U, Ragavendra BN, Reckman EM. The postmenopausal cystic adnexal mass: the potential role of ultrasound in conservative management. Obstet Gynecol 1989;73(1):8-10.
  • 9) Timmerman D, Bourne TH, Tailor A, Collins WP, Vandenberhe K, et. Al A comparison of methods for preoperative discrimination between malignant and benign adnexal masses: The development of a new logistic regression model. Am J Obstet Gynecol 1999;181(1):57-65.
  • 10) Bast RC, Klug TL, John ER. A radioimmunoassay using a monocional antibody to monitor the course of epithelial ovarian cancer. N Eng J Med 1983;309(15):883-7.
  • 11) Jacobs I, Davies AP, Bridgers J et al. Prevalance screening for ovarian cancer in postmenopausal women by CA125 measurement and ultrasonography. BMJ 1993;306(6884):1030-4.
  • 12) O’Connell GJ, Ryan E, Murphy KJ, Prefontaine M. Predictive value of CA125 for ovarian carcinoma in patients presenting with pelvic masses. Obstet Gynecol 1987;70(6):930-2.
  • 13) Olivier RI, Lubsen-Brandsma MA, Berhoef S, van Buerden M. CA125 and transvaginal ultrasound monitoring in high risk women can not prevent the diagnosis of advanced ovarian cancer. Gynecol Oncol 2006;100:20-26.
  • 14) Yüce K. Jinekolojik kanserlerde tumor belirleyicileri (Tumor Marker). In: Guner H editor. Jinekolojik Onkoloji 3.Baskı. Ankara: Cağdaş Medikal Kitabevi; 2002.383-93p.
  • 15) Young RC. Gynecologic malignancies. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, editors. Harrison’s Principles of Internal Medicine. 14th ed. New York; McGraw-Hill; 1998.605-611p.
  • 16) Olson SH, Mignone L, Nakraseive C et al. Symptoms of ovarian cancer. Obstet Gynecol 2001;98:212-217.
  • 17) Bankhead CR, Kehoe ST, Austoker J. Symptoms associated with ovarian cancer: a systematic review. BJOG 2005;112:857–65.
  • 18) Smith LH, Morris CR, Yasmeen S, Parikh-Patel A, Cress RD, Romano PS. Ovarian cancer: can we make the clinical diagnosis earlier? Cancer 2005;104:1398–407.
  • 19) Andersen MR, Goff BA, Lowe KA, Scholler N, Bergan L, Dresher CW, et al. Combining a symptoms index with CA 125 to improve detection of ovarian cancer. Cancer 2008;113:484–9.
  • 20) Goff BA, Mandel LS, Melancon CH, Muntz HG. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA 2004;291:2705–12.
  • 21) Attanucci CA, Ball HG, Zweizig SL, Chen AH. Differences in symptoms between patients with benign and malignant ovarian neoplasms. Am J Obstet Gynecol 2004;190:1435-7.
  • 22) Ryerson AB, Eheman C, Burton J, McCall N, Blackman D, Subramanian S, et al. Symptoms, diagnoses, and time to key diagnostic procedures among older U.S. women with ovarian cancer. Obstet Gynecol 2007;109:1053–61.
  • 23) Goff BA, Mandel LS, Drescher CW. Development of an ovarian cancer symptom index: possibilities for earlier detection Cancer 200;109(2):221-7.

THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES

Year 2018, Volume: 49 Issue: 1, 54 - 58, 05.03.2018
https://doi.org/10.16948/zktipb.346023

Abstract

Objective:
To evaluate the efficiency of Ovarian Cancer Symptom Index questionnaire by
itself to define malignancy in patients with adnexial mass and to evaluate
additional effect of   CA125 and
transvaginal ultrasonography on the index. Materials
and Methods
: 79 patients being prepared for operation because of adnexial
mass in our clinic has been  included in
our study. Ovarian Cancer Symptom Index, CA125, transvaginal ultrasonography
parameters were determined in preoperative term. Types, frequencies, severity
and duration of symptoms were questionned and compared benign and malign cases.
Parameters were compared with histopathology results after the surgery. Results: We did not find difference of
Ovarin Cancer Syptom Index positivity between women with benign and malign
adnexial mass (p>0.05). The sensitivity, specifity, positive predictive
value, negative predictive value of Ovarin Cancer Syptom Index by itself were
%68, %65, 0.41, 0.61 consequently.
When we used The Symptom Index combined with CA125, we
calculated sensitivity %73, spesifity %64, pozitive predictive value 0.32 and
negative predictive value 0,76. The symptoms of abdominal pain, bloating,
distension, eating disorders were significantly different between the groups. We
found that Ultrasonographic Morphologic Scoring System by Sassone et al. was
significant to differentiate malign and benign masses preoperatively.
Conclusion
Contemporary Ovarian Cancer Symptom Index used in this study has not
enough efficiency itself to differentiate malign and benign adnexial masses.
It
would be more useful to arrange a new symptom index for the diagnosis of
ovarian cancer by using the symptoms which were significant to determine
malignancy in our study. 

References

  • 1) Landis SH, Murray T, Bolden S, Wingo PA. Cancer Statistics. Cancer J Clin 1999;49:8-31.
  • 2) Tortolero LG, Mitchell MF. The epidemiology of ovarian cancer. J Cell Biochem Suppl 1995;23:200-207.
  • 3) Kılıç D, Kaya İ, Kamaş A. T.C. Sağlık Bakanlığı. Sağlık İstatistikleri 2002; 2003;653:97.
  • 4) Karlon BY, Plan LD. The current status of ultrasound and color doppler imaging in screening for ovarion cancer. Gynaecol Oncol 1994;55:28-33.
  • 5) Sassone AM, Timor-Tritsch IE, Artner A, Westhoff C, Warren WB. Transvaginal sonographic characterization of ovarian disease: Evaluation of a new scoring system to predict ovarian malignancy. Obstet Gynecol 1991;78:70-6.
  • 6) Piver MS, Baker TR, Piedmonte M, Sandecki AM. Epidemiology and etiology of ovarian cancer. Semin Oncol 1991;18:177-85.
  • 7) Osmers RG, Osmers M, von Maydell B, Wagner B., Kuhn W. Preoperavite evaluation of ovarian tumors in the premenopouse by transvaginosonography. Am J Obstet Gynecol 1996;175(2):428-34.
  • 8) Goldstein SR, Subramanyam B, Synder JR, Beller U, Ragavendra BN, Reckman EM. The postmenopausal cystic adnexal mass: the potential role of ultrasound in conservative management. Obstet Gynecol 1989;73(1):8-10.
  • 9) Timmerman D, Bourne TH, Tailor A, Collins WP, Vandenberhe K, et. Al A comparison of methods for preoperative discrimination between malignant and benign adnexal masses: The development of a new logistic regression model. Am J Obstet Gynecol 1999;181(1):57-65.
  • 10) Bast RC, Klug TL, John ER. A radioimmunoassay using a monocional antibody to monitor the course of epithelial ovarian cancer. N Eng J Med 1983;309(15):883-7.
  • 11) Jacobs I, Davies AP, Bridgers J et al. Prevalance screening for ovarian cancer in postmenopausal women by CA125 measurement and ultrasonography. BMJ 1993;306(6884):1030-4.
  • 12) O’Connell GJ, Ryan E, Murphy KJ, Prefontaine M. Predictive value of CA125 for ovarian carcinoma in patients presenting with pelvic masses. Obstet Gynecol 1987;70(6):930-2.
  • 13) Olivier RI, Lubsen-Brandsma MA, Berhoef S, van Buerden M. CA125 and transvaginal ultrasound monitoring in high risk women can not prevent the diagnosis of advanced ovarian cancer. Gynecol Oncol 2006;100:20-26.
  • 14) Yüce K. Jinekolojik kanserlerde tumor belirleyicileri (Tumor Marker). In: Guner H editor. Jinekolojik Onkoloji 3.Baskı. Ankara: Cağdaş Medikal Kitabevi; 2002.383-93p.
  • 15) Young RC. Gynecologic malignancies. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, editors. Harrison’s Principles of Internal Medicine. 14th ed. New York; McGraw-Hill; 1998.605-611p.
  • 16) Olson SH, Mignone L, Nakraseive C et al. Symptoms of ovarian cancer. Obstet Gynecol 2001;98:212-217.
  • 17) Bankhead CR, Kehoe ST, Austoker J. Symptoms associated with ovarian cancer: a systematic review. BJOG 2005;112:857–65.
  • 18) Smith LH, Morris CR, Yasmeen S, Parikh-Patel A, Cress RD, Romano PS. Ovarian cancer: can we make the clinical diagnosis earlier? Cancer 2005;104:1398–407.
  • 19) Andersen MR, Goff BA, Lowe KA, Scholler N, Bergan L, Dresher CW, et al. Combining a symptoms index with CA 125 to improve detection of ovarian cancer. Cancer 2008;113:484–9.
  • 20) Goff BA, Mandel LS, Melancon CH, Muntz HG. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA 2004;291:2705–12.
  • 21) Attanucci CA, Ball HG, Zweizig SL, Chen AH. Differences in symptoms between patients with benign and malignant ovarian neoplasms. Am J Obstet Gynecol 2004;190:1435-7.
  • 22) Ryerson AB, Eheman C, Burton J, McCall N, Blackman D, Subramanian S, et al. Symptoms, diagnoses, and time to key diagnostic procedures among older U.S. women with ovarian cancer. Obstet Gynecol 2007;109:1053–61.
  • 23) Goff BA, Mandel LS, Drescher CW. Development of an ovarian cancer symptom index: possibilities for earlier detection Cancer 200;109(2):221-7.
There are 23 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Özge Kaymaz Takmaz This is me

Ali Doğukan Anğın

Zehra Meltem Pirimoğlu This is me

Publication Date March 5, 2018
Published in Issue Year 2018 Volume: 49 Issue: 1

Cite

APA Takmaz, Ö. K., Anğın, A. D., & Pirimoğlu, Z. M. (2018). THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES. Zeynep Kamil Tıp Bülteni, 49(1), 54-58. https://doi.org/10.16948/zktipb.346023
AMA Takmaz ÖK, Anğın AD, Pirimoğlu ZM. THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES. Zeynep Kamil Tıp Bülteni. March 2018;49(1):54-58. doi:10.16948/zktipb.346023
Chicago Takmaz, Özge Kaymaz, Ali Doğukan Anğın, and Zehra Meltem Pirimoğlu. “THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES”. Zeynep Kamil Tıp Bülteni 49, no. 1 (March 2018): 54-58. https://doi.org/10.16948/zktipb.346023.
EndNote Takmaz ÖK, Anğın AD, Pirimoğlu ZM (March 1, 2018) THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES. Zeynep Kamil Tıp Bülteni 49 1 54–58.
IEEE Ö. K. Takmaz, A. D. Anğın, and Z. M. Pirimoğlu, “THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES”, Zeynep Kamil Tıp Bülteni, vol. 49, no. 1, pp. 54–58, 2018, doi: 10.16948/zktipb.346023.
ISNAD Takmaz, Özge Kaymaz et al. “THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES”. Zeynep Kamil Tıp Bülteni 49/1 (March 2018), 54-58. https://doi.org/10.16948/zktipb.346023.
JAMA Takmaz ÖK, Anğın AD, Pirimoğlu ZM. THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES. Zeynep Kamil Tıp Bülteni. 2018;49:54–58.
MLA Takmaz, Özge Kaymaz et al. “THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES”. Zeynep Kamil Tıp Bülteni, vol. 49, no. 1, 2018, pp. 54-58, doi:10.16948/zktipb.346023.
Vancouver Takmaz ÖK, Anğın AD, Pirimoğlu ZM. THE WORTHINESS OF OVARY SYMPTOM INDEX, CA125 AND TRANSVAGINAL ULTRASONOGRAPHY IN SCREENING MALIGNANCIES OF ADNEXIAL MASSES. Zeynep Kamil Tıp Bülteni. 2018;49(1):54-8.