Diagnostic Accuracy of Risk of Mallignancy Index (RMI) Based on Serum Ca 125, Ultrasound Score and Menopausal Status in Determining the Malignancy Risk in Adnexal Mass

Abstract

Objective: To determine the Diagnostic Accuracy of Risk of Mallignancy Index (RMI) Based on Serum Ca 125, Ultrasound Score and Menopausal Status in Determining the Malignancy Risk in Adnexal Mass.

Methodology: The cross-sectional study was conducted in the department of Gynae & Obstetrics, Ayub Teaching Complex, Abbottabad. The overall sample size was 271. The Study was approved from the ethical committee of the Ayub Teaching Hospital Abbottabad. Serum CA 125 was carried out at institutional laboratory and menopausal status was assessed. RMI scoring was done as per operational definition. Operative findings during laprotomy of all cases was recorded.  Data was entered in to the computer using SPSS version 17 for analysis.

Results: A total of 271 patients were enrolled in this study. The examination of the different characteristics of RMI indicated that ultrasonography most effectively predict malignancy, with 80% sensitivity and 83% specificity of and a positive probability ratio of 4.4. At a typical cut-off value of 250, the RMI had a positive probability ratio of 8.3, but at a cut-off of 200, it was 6.6, despite same sensitivity and specificity.

Conclusion: When predicting malignant adnexal masses, RMI is a sensitive technique. In underdeveloped nations, a 200 cut-off point would be appropriate for evaluating and early referral to tertiary medical facilities.

Key words: Mallignancy Index, Serum Ca 125, Ultrasound Score; Menopausal Status Malignancy Risk; Adnexal Mass