[Application values of four risk of malignancy indices in the preoperative evaluation of patients with adnexal masses]
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by gemini-2.5-flash-lite, 2026-06-08
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This study evaluated four risk of malignancy indices (RMI) for adnexal masses, finding that RMI2 showed superior diagnostic efficiency, though further study on optimal cutoff levels for Chinese populations is needed.
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by claude@2026-06, 2026-06-24
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The paper evaluates the application value of four malignancy risk indices in the preoperative assessment of patients with adnexal masses, aiming to discriminate benign versus malignant disease. Using a diagnostic-evaluation framework, it compares how the indices perform in preoperative diagnoses and analyzes their usefulness in clinical decision-making based on the risk scores. A key limitation stated or implied is that the results depend on the specific patient cohort and the available preoperative data, which may constrain generalizability to other populations or settings. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.
Abstract
OBJECTIVE: To evaluate the diagnostic values of four risk of malignancy indices (RMI) for malignant adnexal masses.
METHODS: The data of 223 women with adnexal masses admitted to the Department of Obstetrics and Gynecology of Peking Union Medical College Hospital for surgical exploration between June 2008 and December 2008 were retrospectively analyzed. The sensitivity, specificity, positive predictive value and negative predictive value of RMI1, RMI2, RMI3, and RMI4 in the diagnosis of malignant adnexal masses were calculated.
RESULTS: When the cutoff levels of RMI1, RMI2, RMI3 were set at 200 and RMI4 at 450, the sensitivities for diagnosing malignant adnexal masses ranged 59.0%-67.2%, the specificities ranged 94.4%-96.9 %, the positive predictive values ranged 82.0%-87.8%, and the negative predictive values ranged 90.9%-92.6%. The Youdens indexes (YI) of RMI1, RMI2, RMI3, and RMI4 were 0.559,0.606,0.576, and 0.559, respectively. RMI2 was significantly different from RMI1 (P=0.000), RMI3 (P=0.008), and RMI4 (P=0.000) in terms of diagnostic efficiency. RMI1, RMI2, RMI3, and RMI4 at a cutoff level of 75.688.679.1, 177.2 respectively, according to ROC curves, yielded sensitivities of 77.8%-82.5%, specificities of 84.6%-90.1%, positive predictive values of 69.0%-75.4%, and negative predictive values of 90.9%-92.6%; the relevant YI of RMI1, RMI2, RMI3, and RMI4 were 0.635, 0.665, 0.651 and 0.705, respectively. Under this cutoff level, the difference between RMI1, RMI2, RMI3, and RMI4 in diagnosing malignancy had no statistic significant. The primary histological types arising false negative were early stage epithelial ovarian cancer and non-epithelial ovarian cancer. The primary histological types arising false positive were endometriosis masses and degenerative sex cord-stromal tumor.
CONCLUSIONS: RMIs are useful indices for the differentiation between benign and malignant pelvic diseases. Meanwhile, their cutoff levels for Chinese populations need further study.
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四种恶性风险指数在附件肿块良恶性诊断中的应用价值
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Application Values of Four Risk of Malignancy Indices in the Preoperative Evaluation of Patients with Adnexal Masses
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Condition tags
endometriosis
MeSH descriptors
Adnexal Diseases
Risk Assessment
Adnexal Diseases
Adnexal Diseases
Adolescent
Adult
Aged
Aged, 80 and over
CA-125 Antigen
CA-125 Antigen
Female
Humans
Menopause
Middle Aged
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Ultrasonography
Young Adult
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- last seen: 2026-09-19T06:15:14.566301+00:00
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- last seen: 2026-05-13T22:17:07.008521+00:00
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