Pr édictibilité préopératoire de la malignité des tumeurs ovariennes à partir du score ADNEX et utilisation en pratique clinique

Conclusion Notre étude a montré que le score ADNEX permet une bonne prédictibilité des tumeurs ovariennes malignes. Cette prédictibilité est moins satisfaisante pour les patientes plus jeunes. Un seuil de risque de malignité permettant la prise en charge chirurgicale des patientes dans un centre expert a été déterminé pour deux tranches d’âge : un seuil à 5 % pour les patientes de moins de 42ans et un seuil à 10 % pour les patientes de plus de 43ans. Objective The principal aim of this study was the predictability of malignant ovarian tumors and to determine a cut-off value for this score to indicate the risk of malignancy that would be easy to use in clinical practice. Methods We retrospectively calculated the ADNEX score for all patients who underwent surgery for ovarian tumours in two Burgundy hospitals (Dijon University Hospital and Chalon-sur-Saône Hospital). We used the nine criteria of the ADNEX model. The inclusion criteria were the presence of all of the ADNEX criteria and a histology result. We analysed the sensitivity, specificity, PPV and PNV of four cut-offs (3%, 5%, 10% and 15%) for the entire pool then by age groups; from 14 to 42 (group 1) and 43 and more (group 2) Results Two hundred and eighty-four patients managed for an ovarian tumour were included between the 1st January 2013 and the 31st December 2015. Our AUC was of 0.94 (95% CI [0.903–0.977]) for discrimination between benign and malignant ovarian tumors. For a cut-off of 10%, ...
Source: Gynecologie Obstetrique and Fertilite - Category: OBGYN Source Type: research