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악성 위험지수 (Risk of Malignancy Index) 1을 이용한 골반내 종양의 분석
박정우 ( Jung Woo Park ),황성욱 ( Sung Ook Hwang ),박지현 ( Jee Hyun Park ),이병익 ( Byoung Ick Lee ),이정훈 ( Jeong Hoon Lee ),김기원 ( Ki Won Kim ),김경미 ( Kyoung Mi Kim ),정민재 ( Min Jae Jung ),윤내리 ( Nae Ri Yun ),송은섭 ( 대한폐경학회 2013 대한폐경학회지 Vol.19 No.1
Objectives: To assess the ability of risk of malignancy index (RMI) 1 to discriminate between benign and malignant pelvic masses. Methods: Between January 2007 and December 2010, 547 women with pelvic masses were evaluated. Their medical records are reviewed here retrospectively. The sensitivity, specificity and positive and negative predictive values of the cancer antigen (CA) 125 level, ultrasound findings and menopausal status in the prediction of malignant pelvic masses were calculated and compared individually or combined using the RMI 1. Results: The receiver operating characteristic (ROC) curves of CA 125, the ultrasound score and the RMI 1 were all found to be relevant predictors of malignancy. ROC analysis of the RMI 1, CA 125 serum levels, ultrasound score and menopausal status showed areas under the curves of 0.795, 0.782, 0.784 and 0.594, respectively. The RMI 1 was found to be statistically significantly correlated with menopausal status (P = 0.001), while not statistically significantly correlated with CA 125 (P = 0.628) or the ultrasound score (P = 0.541). The RMI 1 at a cut-off of 150 - with a sensitivity of 77.9%, specificity of 81.1%, positive predictive value of 51.7% and negative predictive value of 93.4% - showed the highest performance in determining the malignant tendency of pelvic masses. Conclusion: Accepting a RMI 1 cut-off value of 150 results in statistically more significant diagnostic criteria than menopausal status for the discrimination of benign and malignant pelvic masses. (J Korean Soc Menopause 2013;19:18-25)
박정우 ( Jung Woo Park ),박지현 ( Jee Hyun Park ),송은섭 ( Eun Seop Song ),이병익 ( Byoung Ick Lee ),이정훈 ( Jeong Hoon Le ),김기원 ( Ki Won Kim ),김경미 ( Kyoung Mi Kim ),정민재 ( Min Jae Jung ),윤내리 ( Nae Ri Yun ),황성욱 ( Su 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.9
목적: 수술 전 골반내 종양의 악성 여부를 평가하는 데 있어서 네 가지 악성 위험지수 risk of malignancy indexs (RMIs: RMI 1, RMI 2, RMI 3, and RMI 4)의 효용성을 비교해 보고자 한다. 연구방법: 2007년 1월부터 2010년 12월까지 자궁부속기 종양을 주소로 내원한 환자 547명을 대상으로 한후향적 연구이다. 악성 위험지수는 초음파 소견, 폐경 유무, 종양 크기 및 혈중 CA-125를 바탕으로 산출하였으며, 이를 통해 악성 위험지수의 민감도, 특이도, 양성 및 음성 예측률, 진단 정확도를 구하여 비교하였다. 결과: 수용자 특성 곡선(receiver operating characteristic)상에서 네 악성 위험지수의 곡선 아래의 면적은 각각 0.9233, 0.9151, 0.9132, 0.9263로 나왔다. 네 악성 위험지수는 골반내 종양의 악성 여부를 평가하는데 있어 폐경 유무(P=0.001), 종양의 크기(P=0.03)에 비해서는 통계적으로 유의한 결과를 보였으나, 혈중 CA-125, 초음파 소견(P>0.05)에 비해서는 통계적으로 유의하지 않았다. 결론: 네 악성 위험지수는 수술 전골반내 종양의 악성 여부를 평가하는 데 있어서 폐경 유무와 종양의 크기에 비해 통계적으로 유의하다. Objective: The purpose of this study was to evaluate the ability of the four malignancy risk indices for discrimination of a benign mass from a malignant pelvic mass. Methods: This is a retrospective study of 547 women admitted to the Department of Obstetrics and Gynecology of Inha University College of Medicine, between January, 2007, and December, 2010, for surgical exploration of a pelvic mass. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of four risk of malignancy indices (RMIs: RMI 1, RMI 2, RMI 3, and RMI 4) were obtained for diagnosis of a malignant pelvic mass, Results: Results of receiver operating characteristic analysis of RMI 1-4, CA-125 serum levels, ultrasound score, menopausal status, and tumor size showed values of the area under the curve of 0.9233, 0.9151, 0.9132, 0.9263, 0.8472, 0.9007, 5870, and 0.7714, respectively. The four RMIs showed statistical significance with menopausal status (P=0.001) and tumor size (P=0.03), but not with CA-125 and ultrasound score (P>0.05). Conclusion Four RMIs were found to be statistically significant diagnostic criteria, compared with menopausal status and tumor size, which can discriminate between benign and malignant pelvic masses.