Yıl: 2019 Cilt: 16 Sayı: 4 Sayfa Aralığı: 196 - 200 Metin Dili: İngilizce İndeks Tarihi: 25-01-2021

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

Öz:
Aim: This study aims to assess the malignancy risk in the pre-operativeperiod and compare the effectiveness of the methods used in predicting thediscrimination 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 OncologyOutpatient Clinics, a total of 160 patients who were either in the perimenopausal or postmenopausal period and who were diagnosed with adnexalmasses were included in the study. The patients were assigned into fourrespective groups and to be evaluated with IOTA (International OvarianTumor Analysis), malignancy risk index, morphological index, and the tumor size as determined by the ultrasound. The results of these prospectiveassessments were then compared with the postoperative histopathologicalresults. In the statistical analysis, the probability of being included in themodel was accepted to be 0.05, while, the probability of exclusion from themodel was accepted to be 0.10. The Odds Ratios (OR) were derived fromthe logistic regression, and the level of confidence was determined to be95%. Patients who hadn’t undergone the operation after 120 days fromultrasound 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% and80.8% for IOTA; 50% and 94.1% for the malignancy risk index; 23.5% and94% for the morphological index; and 100% and 31.3% for the tumor sizeas determined by the ultrasound respectively.Conclusion: Owing to the highest level of sensitivity of about 85.7% obtainedby the IOTA models as proven also by large population-based studies, the risk ofmalignancy can be predicted and the surgical approaches can be planned accordingly in the pre-operative period.
Anahtar Kelime:

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

Öz:
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. Gereç ve Yöntemler: 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.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Horner MJ, Ries LAG, Krapcho M at al. SEER cancer statistics rewiev, 1975-2006, National Cancer Institute, SEER website.seer.cancer.gov/ csr/1975-2006. Based on November 2008 SEER data submission. Published May 29, 2009. Accessed August 20, 2013.
  • 2. National Institute of Health Consensus Development Conference Statement. 1994 Ovarian cancer: screening, treatment and follow up. Gynecol Oncol;55:S4.
  • 3.Scully RE. Tumors of the ovary, maldeveloped gonads, fallopian tube and broad ligament. In: Young RH, Clement PB.(eds) Atlas of tumor pathology.3th edition. Washington, DC: Armed Forces Institute of Pathology; 1998. pp51-79.
  • 4.Penson RT, Wenzel LB, Vergote I, Cella D. Quality of life considerations in gynecologic cancer. FIGO 6th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006; 95(Suppl 1): S247-57.
  • 5.Webb PM, Purdie DM, Grover S, Jordan S, Dick ML, Green AC. Symptoms and diagnosis of borderline, early and advanced epithelial ovarian cancer. Gynecol Oncol. 2004;92:232-9.
  • 6.Timmerman D. Lack of standardization in gynecological ultrasonography. Ultrasound Obstet Gynecol. 2000;16:395-98.
  • 7.DePriest PD, Varner E, Powell J, Fried A, Puls L, Higgins R. The efficacy of a sonographic morphology index in identifying ovarian cancer: a multi-institutional investigation. Gynecol Oncol. 1994; 55: 174–8.
  • 8.Manjunath AP, Pratapkumar, Sujatha K, Vani R. Comparison of three risk of malignancy indices in evaluation of pelvic masses. Gynecol Oncol .2001;81:225–9.
  • 9.Partridge EE, Barnes MN. Epithelial Ovarian Cancer: Prevention, Diagnosis, and Treatment. CA Cancer J Clin. 1999;49:297-320.
  • 10.Shalev E, Eliyahu S, Peleg, Tsabari A. Laparoscopic management of adnexal cystic masses in postmenopausal women. Obstet Gynecol. 1994;83:594-9.
  • 11.Atasü T, Şahmay S. Bening Neoplasms of Ovary. In: Atasü T, Şahmay S.(eds) Gynecology. 2nd edition. Nobel Medical Bookstore Istanbul 2001: pp 339-347.
  • 12.Granberg S, Wikland M, Jansson I. Macroscopic characterization of ovarian tumors and the relation to the histological diagnosis: criteria to be used for ultrasound evaluation. Gynecol Oncol. 1989; 35:139–44.
  • 13.Jacobs IJ, Oram D, Fairbanks J, Turner J, Frost C, Grudzinskas JG. A risk of malignancy index incorporating CA125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynaecol. 1990;97:922–9.
  • 14.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.
  • 15.Van Calster B, Timmerman D, Bourne T. Discrimination between benign and malignant adnexal masses by specialist ultrasound examination versus serum CA-125. J Natl Cancer Inst 2007;99:1706–14.
  • 16.Timmerman D, Valentin L, Bourne TH, Collins WP, Verrelst H, Vergote I. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet Gynecol. 2000;16:500–5.
  • 17.Twickler M, Moschos E. Ultrasound and assessment of ovarian cancer risk. AJR Women’s Imaging. 2010;194:322-9.
  • 18.Van Calster B, Timmerman D, Lu C, Suykens JA, Valentin L. Preoperative diagnosis of ovarian tumors using Bayesian kernel-based methods. Ultrasound Obstet Gynecol. 2007;29:496–504.
  • 19.Timmerman D., Ameye L., Fischerova D., Epstein E., Melis GB. Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by the IOTA group. BMJ. 2010;110:341-50.
  • 20.Timmerman D, Van Calster B., Testa AC., Guerriero S., Ovarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group. Ultrasound Obstet Gynecol. 2010;36: 226–34.
APA GÜVEY H, Doganay M, Bozkurt Koseoglu S, Türker M, Gungor T (2019). 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. , 196 - 200.
Chicago GÜVEY HURİ,Doganay Melike,Bozkurt Koseoglu Sezen,Türker Mengü,Gungor Tayfun 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. (2019): 196 - 200.
MLA GÜVEY HURİ,Doganay Melike,Bozkurt Koseoglu Sezen,Türker Mengü,Gungor Tayfun 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. , 2019, ss.196 - 200.
AMA GÜVEY H,Doganay M,Bozkurt Koseoglu S,Türker M,Gungor T 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. . 2019; 196 - 200.
Vancouver GÜVEY H,Doganay M,Bozkurt Koseoglu S,Türker M,Gungor T 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. . 2019; 196 - 200.
IEEE GÜVEY H,Doganay M,Bozkurt Koseoglu S,Türker M,Gungor T "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." , ss.196 - 200, 2019.
ISNAD GÜVEY, HURİ vd. "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". (2019), 196-200.
APA GÜVEY H, Doganay M, Bozkurt Koseoglu S, Türker M, Gungor T (2019). 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. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 16(4), 196 - 200.
Chicago GÜVEY HURİ,Doganay Melike,Bozkurt Koseoglu Sezen,Türker Mengü,Gungor Tayfun 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. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 16, no.4 (2019): 196 - 200.
MLA GÜVEY HURİ,Doganay Melike,Bozkurt Koseoglu Sezen,Türker Mengü,Gungor Tayfun 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. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, vol.16, no.4, 2019, ss.196 - 200.
AMA GÜVEY H,Doganay M,Bozkurt Koseoglu S,Türker M,Gungor T 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. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2019; 16(4): 196 - 200.
Vancouver GÜVEY H,Doganay M,Bozkurt Koseoglu S,Türker M,Gungor T 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. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2019; 16(4): 196 - 200.
IEEE GÜVEY H,Doganay M,Bozkurt Koseoglu S,Türker M,Gungor T "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." Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 16, ss.196 - 200, 2019.
ISNAD GÜVEY, HURİ vd. "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". Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 16/4 (2019), 196-200.