An original risk of ovarian malignancy index and its predictive value in evaluating the nature of ovarian tumour

  • Vesna Antovska University Clinic St Cyril and Methodius Skopje
  • Milka Trajanova University Clinic of Gynecology St. Cyril and Methodius Skopje
Keywords: ovarian cancer, serum cancer antigen 125, CA-125, ultrasound, risk of ovarian malignancy index

Abstract

Background: We carried out this study to evaluate the predictive value of an original risk of ovarian malignancy index (ROMI) devised by us. Method: Our ROMI was the simple sum of points from the three-stage gradation of serum cancer antigen 125 (CA-125), data from the patient’s familial and personal history and the ultrasound characteristics of the tumour (i.e. tumour size ≥ 6 cm, multilocularity, tumour with ≥ ¼ solid areas, dense and opalescent liquid, septum or papillary vegetation ≥ 3 mm), ascites, bilaterality, an unclear margin with respect to the surrounding tissue and thickness of the capsule ≥ 3 mm. Its originality lay in the three-stage CA-125 gradation, namely < 35 U/ml (1 point), 35-129 U/ml (3 points) and ≥ 130 U/ml (5 points). The study group comprised 274 patients divided into a group with benign tumours (BOT) (n = 205), and a group with malignant tumours (MOT) (n = 69). Both groups were subdivided into three subgroups of ROMI ≤ 11 (low risk), ROMI 12-14 (unclear risk) and ROMI ≥ 15 (high risk). Results: The cut-off ROMI of ≤ 11 showed high sensitivity, specificity and area under the curve (AUC) of 0.74, 0.93 and 0.83, respectively. The cut-off ROMI of ≤ 14 demonstrated extremely high specificity of 0.985, but lower sensitivity and AUC, of 0.57 and 0.78, respectively. Conclusion: Our newly devised ROMI and its cut-off of ≤ 11 is very effective in excluding, as well as confirming, ovarian cancer.

Author Biographies

Vesna Antovska, University Clinic St Cyril and Methodius Skopje
PhD Professor Department of Urogynecology University Clinic St Cyril and Methodius Skopje Skopje Macedonia
Milka Trajanova, University Clinic of Gynecology St. Cyril and Methodius Skopje
Department of Urogynecology University Clinic of Gynecology St. Cyril and Methodius Skopje
Published
2015-07-07
Section
Original Research