Salcedo-Hernández Rosa A, Cantú-de-León David F, Pérez-Montiel Delia, García-Pérez Leticia, Lino-Silva Leonardo S, Zepeda-Najar César, Barquet-Muñoz Salim A
Surgical Oncology, National Cancer Institute, Mexico City, Mexico.
Gynecologic Oncology, National Cancer Institute, Mexico City, Mexico.
Ann Transl Med. 2021 Feb;9(3):261. doi: 10.21037/atm-20-3932.
Borderline ovarian tumors (BTs) must be recognized during the surgery by intraoperative consultation (IOC) to guide surgical treatment; however, this diagnosis can be imprecise. Therefore, this study aimed to evaluate the diagnostic accuracy of IOC for the diagnosis of BT.
A retrospective cohort study was carried out including all women diagnosed with a pelvic tumor consecutively surgically treated from 2005 to 2015 with IOC. We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LR) for the IOC and BTs.
A total of 758 patients were enrolled, the median age was 44 years, the median tumor size was 11.8 cm, and the median CA-125 levels were 45.65 U/µL. After IOC, 458 (64.1%) cases were diagnosed as benign, 111 (14.7%) as BT, and 161 (21.2%) as malignant. The definitive diagnosis was a benign tumor in 448 (59.1%) cases, BT in 110 (14.5%), and 200 (26.4%) cases were malignant. The diagnostic accuracy of the IOC for BT diagnosis was 89.8% (sensitivity =65.5%, specificity =93.9%). The diagnosis performance of IOC for the diagnosis between BT and benign tumors (n=546) had a sensitivity of 69.9%, a specificity of 98.4%, and a diagnostic accuracy of 84%; meanwhile for the diagnosis between BT and malignant tumors (n=242) IOC had a sensitivity of 92.3%, a specificity of 81.7%, and a diagnostic accuracy of 87%.
For practitioners, knowing the accuracy and limitations of the IOC for BT enables the better selection of cases to perform a complete staging surgery.
交界性卵巢肿瘤（BTs）必须在手术期间通过术中会诊（IOC）来识别，以指导手术治疗；然而，这种诊断可能并不精确。因此，本研究旨在评估IOC对BT诊断的准确性。
开展一项回顾性队列研究，纳入2005年至2015年期间所有通过IOC接受手术治疗的盆腔肿瘤女性患者。我们计算了IOC诊断BTs的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和似然比（LR）。
共纳入758例患者，中位年龄为44岁，中位肿瘤大小为11.8 cm，中位CA-125水平为45.65 U/µL。IOC后，458例（64.1%）被诊断为良性，111例（14.7%）为BT，161例（21.2%）为恶性。最终诊断为良性肿瘤448例（59.1%），BT 110例（14.5%），恶性200例（26.4%）。IOC诊断BT的准确性为89.8%（敏感性=65.5%，特异性=93.9%）。IOC在BT与良性肿瘤（n = 546）之间诊断的性能，敏感性为69.9%，特异性为98.4%，诊断准确性为84%；同时，在BT与恶性肿瘤（n = 242）之间诊断时，IOC的敏感性为92.3%，特异性为81.7%，诊断准确性为87%。
对于从业者而言，了解IOC诊断BT的准确性和局限性有助于更好地选择病例进行完整的分期手术。
