THE ROLE OF PREDICTION MODELS IN THE CLASSIFICATION OF ADNEXAL MASS
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.
Reference
1. Timmerman D, Planchamp F, Bourne T, Landolfo C, du Bois A, Chiva L, et al. ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors. Int J Gynecol Cancer. 2021;31(7):961-982.
2. Timmerman D, Valentin L, Bourne TH, Collins WP, Verrelst H, Vergote I. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet Gynecol 2000;16(5):500–5.
3. Glanc P, Benacerraf B, Bourne T, Brown D, Coleman BG, Crum C, et al. First International Consensus Report on Adnexal Masses: Management Recommendations. J Ultrasound Med. 2017;36(5):849–63.
4. Republička stručna komisija za izradu i implementaciju vodiča dobre kliničke prakse, [Šternić Čoviković N urednik], NACIONALNI vodič dobre kliničke prakse za dijagnostikovanje i lečenje karcinoma ovarijuma. Ministarstvo zdravlja Republike Srbije, Beograd, 2013.
5. Asch E, Levine D, Kim Y. Histologic, surgical, and imaging correlations of adnexal masses. J Ultrasound Med. 2008;27(3):327-42
6. Sayasneh A, Ekechi C, Ferrara L, Kaijser J, Stalder C, Sur S, et al. The characteristic ultrasound features of specific types of ovarian pathology (Review). Int J Oncol. 2015;46(2):445–58.
7. Alcázar JL, Guerriero S, Laparte C, Ajossa S, Ruiz-Zambrana Á, Melis GB. Diagnostic performance of transvaginal gray-scale ultrasound for specific diagnosis of benign ovarian cysts in relation to menopausal status. Maturitas. 2011;68(2):182–8.
8. Meys EMJ, Kaijser J, Kruitwagen RFPM, Slangen BFM, Van Calster B, Aertgeerts B, et al. Subjective assessment versus ultrasound models to diagnose ovarian cancer: A systematic review and meta-analysis. Eur J Cancer 2016;58:17–29.
9. Meys EMJ, Jeelof LS, Achten NMJ, Slangen BFM, Lambrechts S, Kruitwagen RFPM, et al. Estimating risk of malignancy in adnexal masses: external validation of the ADNEX model and comparison with other frequently used ultrasound methods. Ultrasound Obstet Gynecol. 2017;49(6):784–92.
10. Van Holsbeke C, Daemen A, Yazbek J, Holland TK, Bourne T, Mesens T, et al. Ultrasound experience substantially impacts on diagnostic performance and confidence when adnexal masses are classified using pattern recognition. Gynecol Obstet Invest. 2010;69(3):160–8.
11. Timmerman D, Schwärzler P, Collins WP, Claerhout F, Coenen M, Amant F, et al. Subjective assessment of adnexal masses with the use of ultrasonography: An analysis of interobserver variability and experience. Ultrasound Obstet Gynecol. 1999;13(1):11-6
12. Charkhchi P, Cybulski C, Gronwald J, Wong FO, Narod SA, Akbari MR. CA125 and Ovarian Cancer: A Comprehensive Review. Cancers (Basel). 2020; 12(12):3730.
13. Gotlieb WH, Soriano D, Achiron R, Zalel Y, Davidson B, Kopolovic J, et al. CA 125 measurement and ultrasonography in borderline tumors of the ovary. Am J Obstet Gynecol. 2000;183(3):541–6.
14. Urban N, Thorpe JD, Bergan LA, Forrest RM, Kampani A V., Scholler N, et al. Potential role of HE4 in multimodal screening for epithelial ovarian cancer. J Natl Cancer Inst. 2011;103(21):1630–4.
15. Ferraro S, Braga F, Lanzoni M, Boracchi P, Biganzoli EM, Panteghini M. Serum human epididymis protein 4 vs carbohydrate antigen 125 for ovarian cancer diagnosis: A systematic review. J Clin Pathol. 2013;66(4):273–81.
16. Moore RG, Scott Mcmeekin D, Brown AK, Disilvestro P, Miller MC, Allard WJ, et al. A novel multiple marker bioassay utilizing HE4 and CA125 for the prediction of ovarian cancer in patients with a pelvic mass. Gynecol Oncol. 2009;112(1):40-6
17. Scaletta G, Plotti F, Luvero D, Capriglione S, Montera R, Miranda A, et al. The role of novel biomarker HE4 in the diagnosis, prognosis and follow-up of ovarian cancer: a systematic review. Expert Rev Anticancer Ther. 2017;17(9):827–39.
18. Van Gorp T, Cadron I, Despierre E, Daemen A, Leunen K, Amant F, et al. HE4 and CA125 as a diagnostic test in ovarian cancer: Prospective validation of the Risk of Ovarian Malignancy Algorithm. Br J Cancer. 2011;104(5):863–70.
19. Karlsen MA, Høgdall EVS, Christensen IJ, Borgfeldt C, Kalapotharakos G, Zdrazilova-Dubska L, et al. A novel diagnostic index combining HE4, CA125 and age may improve triage of women with suspected ovarian cancer - An international multicenter study in women with an ovarian mass. Gynecol Oncol. 2015;138(3):640–6.
20. Kaijser J, Sayasneh A, Hoorde K Van, Ghaem-maghami S, Bourne T, Timmerman D, et al. Presurgical diagnosis of adnexal tumours using mathematical models and scoring systems : a systematic review and meta-analysis. Hum Reprod Update. 2014;20(3):449-62
21. Jacobs I, Oram D, Fairbanks J, Turner J, Frost C, Grudzinskas JG. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynaecol. 1990;97(10):922–9.
22. Tingulstad S, Hagen B, Skjeldestad FE, Onsrud M, Kiserud T, Halvorsen T, et al. Evaluation of a risk of malignancy index based on serum CA125, ultrasound findings and menopausal status in the pre-operative diagnosis of pelvic masses. Br J Obstet Gynaecol. 1996;103(8):826–31.
23. Tingulstad S, Hagen B, Skjeldestad FE, Halvorsen T, Nustad K, Onsrud M. The risk-of-malignancy index to evaluate potential ovarian cancers in local hospitals. Obstet Gynecol. 1999;93(3):448–52.
24. Yamamoto Y, Yamada R, Oguri H, Maeda N, Fukaya T. Comparison of four malignancy risk indices in the preoperative evaluation of patients with pelvic masses. Eur J Obstet Gynecol Reprod Biol. 2009;144(2):163–7.
25. Aktürk E, Karaca RE, Alanbay I, Dede M, Karaşahin E, Yenen MC, et al. Comparison of four malignancy risk indices in the detection of malignant ovarian masses. J Gynecol Oncol. 2011;22(3):177–82.
26. RCOG. Management of suspected ovarian masses in premenopausal women: Green-top Guideline No.62. R Coll Obstet Gynaecol 2011;(62):1–14.
27. Royal College of Obstetricians and Gynaecologists. The Management of Ovarian Cysts in Postmenopausal Women. Green-top Guideline No. 34. RCOG. 2016
28. Geomini P, Kruitwagen R, Bremer GL, Cnossen J, Mol BWJ. The accuracy of risk scores in predicting ovarian malignancy: A systematic review. Obstet Gynecol. 2009;113:384–94.
29. Timmerman D, Testa AC, Bourne T, Ameye L, Jurkovic D, Van Holsbeke C, et al. Simple ultrasound-based rules for the diagnosis of ovarian cancer. Ultrasound Obstet Gynecol. 2008;31(6):681–90.
30. Timmerman D, Ameye L, Fischerova D, Epstein E, Melis GB, Guerriero S, et al. Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: Prospective validation by IOTA group. BMJ. 2010;14;341:c6839
31. Nunes N, Ambler G, Foo X, Naftalin J, Widschwendter M, Jurkovic D. Use of IOTA simple rules for diagnosis of ovarian cancer: Meta-analysis. Ultrasound Obstet Gynecol. 2014;44(5):503–14.
32. Sayasneh A, Kaijser J, Preisler J, Smith AA, Raslan F, Johnson S, et al. Accuracy of ultrasonography performed by examiners with varied training and experience in predicting specific pathology of adnexal masses. Ultrasound Obstet Gynecol. 2015;45(5):605–12.
33. Van Calster B, Van Hoorde K, Valentin L, Testa AC, Fischerova D, Van Holsbeke C, et al. Evaluating the risk of ovarian cancer before surgery using the ADNEX model to differentiate between benign, borderline, early and advanced stage invasive, and secondary metastatic tumours: Prospective multicentre diagnostic study. BMJ. 2014 Oct 15;349.
34. Van Calster B, Van Hoorde K, Froyman W, Kaijser J, Wynants L, Landolfo C, et al. Practical guidance for applying the ADNEX model from the IOTA group to discriminate between different subtypes of adnexal tumors. Facts, views Vis ObGyn. 2015;7(1):32–41.
35. Calster B Van, Hoorde K Van, Valentin L, Testa AC, Fischerova D, Holsbeke C Van, et al. Evaluating the risk of ovarian cancer before surgery using the ADNEX model to differentiate between benign, borderline, early and advanced stage invasive, and secondary metastatic tumours : prospective multicentre diagnostic study. 2014;5920:1–14.
36. Szubert S, Wojtowicz A, Moszynski R, Zywica P, Dyczkowski K, Stachowiak A, et al. External validation of the IOTA ADNEX model performed by two independent gynecologic centers. Gynecol Oncol. 2016;142(3):490–5.