BioMedica |

Original Article

VOLUME: 38 | ISSUE: 4 | Dec 30, 2022 | PAGE: (209 - 213) | DOI: 10.24911/BioMedica/5-772

Risk of malignancy index: a useful tool in primary evaluation of ovarian masses at tertiary care center in Pakistan

Authors: Rabia Nafees , Humaira Zareen , Zoofishan Imran , Dr Maujid Masood Malik , Assistant Professor Shazia Jang Sher

Article Info

Authors

Rabia Nafees

Department of Obstetrics & Gynaecology, Post Graduate Medical Institute, Lahore General Hospital, Lahore, Pakistan.

Humaira Zareen

Department of Obstetrics & Gynecology, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia

Zoofishan Imran

Department of Community Medicine, Combined Military Hospital Medical College, Lahore, Pakistan

Dr Maujid Masood Malik

Department of Biomedical Sciences, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia

Assistant Professor Shazia Jang Sher

Department of Obstetrics and Gynecology, Bakhtawar Amin Trust Teaching Hospital, Multan, Pakistan

Publication History

Received: July 04, 2022

Revised: November 17, 2022

Accepted: December 10, 2022

Published: December 30, 2022

Abstract

Background and Objective: The discrimination between benign and malignant adnexal masses is important for clinical management and surgical planning in such patients. The risk of malignancy index (RMI) is a combined parameter that is a simple, highly sensitive, and more specific scoring system based on three factors: serum cancer antigen 125 (CA-125) levels, ultrasonographic (USG) score, and menopausal status. The objective of the study is to evaluate the diagnostic efficacy of RMI for the primary evaluation of ovarian masses in females presenting at a local tertiary care hospital in Pakistan.

Methods: This prospective observational study was carried out at the Gynecology outdoor clinic of Fouji Foundation Hospital, Rawalpindi, Pakistan. The study comprised 141 females admitted for surgical exploration of ovarian masses. Pre-operative USG evaluations of ovarian mass, menopausal status, and serum CA-125 levels were determined for all the patients. RMI was calculated and post-operative histopathology of resected ovarian masses was done in all the cases to confirm the diagnosis.

Results: The sensitivity and specificity of CA-125 alone at a cut-off value of 35 U/ml was 67.64% and 83.17% respectively. Using a cutoff value for RMI at 200 U/ml, the specificity and sensitivity of CA-125 were 85.98% and 76.47%, respectively. The receiver operating characteristic curve revealed that RMI was a better discriminate than CA-125, ultrasound, and menopausal status alone.

Conclusion: The RMI is a useful tool in the primary evaluation of ovarian masses. It can be used to differentiate between benign and malignant ovarian masses with high sensitivity and specificity. Suspected malignant patients can be referred to a gynecological oncologist for further management.

Keywords: Risk of malignancy index (RMI), receiver operating curve (ROC), cancer antigen 125 (CA-125), ovarian masses, menopause, ovarian cancer, ovarian tumor.

Pubmed Style

Rabia Nafees, Humaira Zareen, Zoofishan Imran, Dr Maujid Masood Malik, Assistant Professor Shazia Jang Sher. Risk of malignancy index: a useful tool in primary evaluation of ovarian masses at tertiary care center in Pakistan. BioMedica. 2023; 07 (March 2023): 209-213. doi:10.24911/BioMedica/5-772

Web Style

Rabia Nafees, Humaira Zareen, Zoofishan Imran, Dr Maujid Masood Malik, Assistant Professor Shazia Jang Sher. Risk of malignancy index: a useful tool in primary evaluation of ovarian masses at tertiary care center in Pakistan. https://biomedicapk.com/10.51441/BioMedica/5-772 [Access: March 28, 2023]. doi:10.24911/BioMedica/5-772

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Rabia Nafees, Humaira Zareen, Zoofishan Imran, Dr Maujid Masood Malik, Assistant Professor Shazia Jang Sher. Risk of malignancy index: a useful tool in primary evaluation of ovarian masses at tertiary care center in Pakistan. BioMedica. (2023), [cited March 28, 2023]; 07 (March 2023): 209-213. doi:10.24911/BioMedica/5-772

Harvard Style

Rabia Nafees, Humaira Zareen, Zoofishan Imran, Dr Maujid Masood Malik, Assistant Professor Shazia Jang Sher (2023) Risk of malignancy index: a useful tool in primary evaluation of ovarian masses at tertiary care center in Pakistan. BioMedica, 07 (March 2023): 209-213. doi:10.24911/BioMedica/5-772

Chicago Style

Rabia Nafees, Humaira Zareen, Zoofishan Imran, Dr Maujid Masood Malik, Assistant Professor Shazia Jang Sher. "Risk of malignancy index: a useful tool in primary evaluation of ovarian masses at tertiary care center in Pakistan." 07 (2023), 209-213. doi:10.24911/BioMedica/5-772

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Rabia Nafees, Humaira Zareen, Zoofishan Imran, Dr Maujid Masood Malik, Assistant Professor Shazia Jang Sher (2023) Risk of malignancy index: a useful tool in primary evaluation of ovarian masses at tertiary care center in Pakistan. , 07 (March 2023), 209-213. doi:10.24911/BioMedica/5-772