Ozbay Pelin Ozun, Ekinci Tekin, Caltekin Melike Demir, Yilmaz Hasan Taylan, Temur Muzaffer, Yilmaz Ozgur, Uysal Selda, Demirel Emine, Kelekci Sefa
Department of Obstetrics and Gynecology, Aydin Obstetrics and Pediatrics Hospital, Aydin, Turkey E-mail :
Asian Pac J Cancer Prev. 2015;16(1):345-9. doi: 10.7314/apjcp.2015.16.1.345.
To determine the cut-off values of the preoperative risk of malignancy index (RMI) used in differentiating benign or malignant adnexal masses and to determine their significance in differential diagnosis by comparison of different systems.
191 operated women were assessed retrospectively. RMI of 1, 2, 3 and 4; cut-off values for an effective benign or malignant differentiation together with sensitivity, specificity, negative and positive predictive values were calculated.
Cut-off value for RMI 1 was found to be 250; there was significant (p<0.001) compatibility at this level with sensitivity of 60%, positive predictive value (PPV) of 75%, specificity of 93%, negative predictive value (NPV) of 88% and an overall compliance rate of 85%. When RMI 2 and 3 was obtained with a cut-off value of 200, there was significant (p<0.001) compatibility at this level for RMI 2 with sensitivity of 67%, PPV of 67%, specificity of 89%, NPV of 89%, histopathologic correlation of 84% while RMI 3 had significant (p<0.001) compatibility at the same level with sensitivity of 63%, PPV of 69%, specificity of 91%, NPV of 88% and a histopathologic correlation of 84%. Significant (p<0.001) compatibility for RMI 4 with a sensitivity of 67%, PPV of 73%, specificity of 92%, NPV of 89% and a histopathologic correlation of 86% was obtained at the cut-off level 400.
RMI have a significant predictability in differentiating benign and malignant adnexal masses, thus can effectively be used in clinical practice.
确定用于区分附件包块良恶性的术前恶性风险指数（RMI）的临界值，并通过比较不同系统来确定其在鉴别诊断中的意义。
对191例接受手术的女性进行回顾性评估。计算RMI为1、2、3和4时有效区分良恶性的临界值以及敏感度、特异度、阴性和阳性预测值。
发现RMI 1的临界值为250；在此水平上存在显著（p<0.001）的一致性，敏感度为60%，阳性预测值（PPV）为75%，特异度为93%，阴性预测值（NPV）为88%，总体符合率为85%。当RMI 2和3的临界值为200时，RMI 2在此水平上存在显著（p<0.001）的一致性，敏感度为67%，PPV为67%，特异度为89%，NPV为89%，组织病理学相关性为84%；而RMI 3在此相同水平上存在显著（p<0.001）的一致性，敏感度为63%，PPV为69%，特异度为91%，NPV为88%，组织病理学相关性为84%。RMI 4在临界值为400时存在显著（p<0.001）的一致性，敏感度为67%，PPV为73%，特异度为92%，NPV为89%，组织病理学相关性为86%。
RMI在区分附件包块良恶性方面具有显著的预测性，因此可有效地应用于临床实践。
