abstract
OBJECTIVE:
To
develop a new scoring system based on menopausal status, ultrasound
(US) findings, serum cancer antigen 125 (CA125) and human epididymis
protein 4 (HE4) to predict ovarian cancer (OC) in women presenting with a
pelvic or adnexal mass.
CONCLUSIONS:
The
new R-OPS scoring system showed good discrimination between
non-cancerous lesions and OC. However, a prospective study in a
different setting is required to confirm these preliminary data.
METHODS:
Consecutive
female patients aged over 18years with pelvic or adnexal masses
investigated preoperatively by pelvic US, serum CA125 and HE4 who
underwent elective surgery were enrolled. The "Rajavithi-Ovarian Cancer
Predictive Score (R-OPS)" was developed using data from 2012 and
validated using data from 2013 to 2014. The diagnosis of OC was based on
pathological findings. Data were analyzed by logistic regression and
area under the receiver operating characteristic curve (ROC-AUC).
RESULTS:
Based
on a development set of 260 women including 74 with OC, menopausal
status (M), serum CA125 and HE4, and US findings of solid lesions (U)
were identified as significant predictors of OC. R-OPS=M×U×(CA125×HE4)
1/2
revealed good calibration (goodness-of-fit test, p=0.972) and
discrimination (ROC-AUC=92.8%). Performance validation in 266 women, 82
with OC, showed good discrimination with ROC-AUC of 94.9%. Performance
in the validation sample with a cutoff value of R-OPS>330 revealed
sensitivity, specificity, and positive and negative predictive values of
93.9%, 79.9%, 67.5%, and 96.7%, respectively.
CONCLUSIONS:
The
new R-OPS scoring system showed good discrimination between
non-cancerous lesions and OC. However, a prospective study in a
different setting is required to confirm these preliminary data.
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