THE ROLE OF PREDICTION MODELS IN THE CLASSIFICATION OF ADNEXAL MASS

  • Zoran Vilendečić Klinika za ginekologiju i akušerstvo, Univerzitetski klinički centar Srbije
  • Aleksandar Stefanovic Klinika za ginekologiju i akušerstvo, Univerzitetski klinički centar Srbije
Ključne reči: ultrasound, adnexal mass, prediction model, simple rules, subjective assessment, ADNEX model, risk of malignancy index

Sažetak


Prediktivni modeli imaju važnu ulogu u evaluaciji adneksalnih masa jer omogućavaju kliničarima pouzdanu diferencijaciju benignih i malignih adneksalnih masa. Modeli koriste kliničke i ultrazvučne karakteristike na osnovu kojih se generiše numerički skor ili verovatnoća za postojanje maligniteta. 

Upotreba prediktivnih modela u proceni adneksalnih masa ima nekoliko prednosti. Na ovaj način kliničari mogu identifikovati pacijentkinje koje su u povišenom riziku od postojanja maligniteta i time kandidati za hirurški tretman. Modeli mogu biti osnova za donošenje daljih kliničkih odluka kao što su sprovođenje dodatnog imidžinga i planiranje opsega operativnog zahvata. 

Risk of Malignancy Index (RMI) je model koji inkorporira menopauzalni status pacijentkinje, ultrazvučne karakteristike adneksalne mase i serumske vrednosti kancer antigena 125. Model jednostavnih pravila je jednostavan i reproducibilan prediktivni model koji koristi izabrane ultrazvučne karakteristike (označene kao B i M karakteristike). Assessment of Different NEoplasias in the adneXa (ADNEX) model koristi kliničke i ultrazvučne karakteristike za procenu verovatnoće za postojanje različitih grupa maligniteta. Maligniteti su ovim modelom dalje podeljeni na border-line tumore invazivni ovarijalni kancer stadijuma I, invazivni ovarijalni kancer stadijuma II do IV i sekundarne ovarijalne malignitete. Ova karakteristika omogućava kliničarima individualizovan pristup pacijentkinjama sa adneksalnom masom. 

Uopšteno, upotreba prediktivnih modela u evaluaciji adneksalnih masa može biti korisna u svakodnevnoj kliničkoj praksi, ali odluku o daljem dijagnostičkom ili terapijskom postupku treba donositi u skladu sa kliničkim kontekstom uvažavajući želje pacijentkinje.

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2024/05/08
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