Evaluation of Ovarian Tumors by RMI(risk of malignancy index); -Based on Serum CA-125, Ultrasound Findings and Menopausal Status

Lee, Jae Jun; Choi, Young Tai; Han, Ji Won; Kim, Woo Gyeong; Kim, Ki Tae; Kim, Hyun Chan

Abstract

The purpose of this clinical study was to evaluate the efficacy of RMI(risk of malignancy index) as a preoperative predictive screening method in ovarian tumors. The RMI was calculated by the following formula; -RMI=The ultrasonographic score(0, 1, or 3) x serum CA-125 level x menopausal status score(1 or 3). The preoperative RMI was obtained from 69 cases of ovarian tumors operated from July 1993 to March 1996 at the Dept. of Obstetrics and Gynecology, Pusan Paik Hosp. Reviewing the histopathological diagnosis of surgical specimen, using RMI cut-off value of 200, the sensitivity, specificity, positive and negative predictive value of RMI was obtained and compared with CA-125 value and sonographic scores, respectively. The results obtained were as follows; 1. The sensitivity of RMI was 67.7%, it was lower than that of serum CA-125 value(74.0%) and ultrasonographic score(80.6%)(P=0.535). 2. The specificity of RMI was 100%, it was higher than that of serum CA-125 value(81.6 %) and ultrasonographic score(84.2%)(P=0.006). 3. The positive predictive value of RMI was 100%, it was higher than that of serum CA-125 value(76.7%) and ultrasonographic score(80.6%)(P=0.047). 4. The negative predictive value of RMI was 79.2%, it was lower than that of CA-125 value(79.5%) and ultraconographic score(84.2%)(P=0.83). In conclusion, the RMI could be a useful screening method to discriminate a benign from malignant ovarian tumors prior to operation.