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Obstet Gynecol Sci > Epub ahead of print
DOI: https://doi.org/10.5468/ogs.21012    [Epub ahead of print]
Published online February 17, 2021.
Assessment of different NEoplasias in the adneXa model for differentiation of benign and malignant adnexal masses in Korean women
Gina Nam1, Sa Ra Lee2  , Kyungah Jeong3, Sung Hoon Kim2, Hye-Sung Moon3, Hee Dong Chae2
1Department of Obstetrics and Gynecology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
2Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea
Correspondence:  Sa Ra Lee,
Email: leesr@amc.seoul.kr
Received: 2 January 2021   • Revised: 29 January 2021   • Accepted: 8 February 2021
Abstract
Objective
Ultrasonographic differential diagnosis of ovarian tumors is important for appropriate management. We conducted study to compare the performance of the Assessment of Different NEoplasias in the adneXa (ADNEX) model with a subjective assessment (SA) in differentiating between benign and malignant adnexal masses in Korean women.
Methods
A total of 353 patients who underwent adnexal surgery with abnormal pelvic ultrasonographic findings from August 2016 to August 2017 were included in study. The presumptive diagnosis of adnexal malignancy was determined by both SA and the ADNEX model to be >10% calculated risk of malignancy. The area under the curve (AUC) comparison between the SA and ADNEX models was performed using DeLong’s method.
Results
340 patients with benign tumors and 13 with malignant adnexal tumors among 292 (82.72%) premenopausal and 61 (17.28%) postmenopausal women were included. The AUCs of SA and the ADNEX model for discrimination between benign and malignant tumors were 0.79 and 0.92, respectively (P=0.10). The sensitivity and specificity of SA and the ADNEX model were 83.5% and 97.0%, and 90.0% and 82.0%, respectively. Comparison of the ADNEX model regarding menopausal status revealed that the predictability was not different. The AUCs of SA and the ADNEX model in premenopausal women were 0.74 and 0.89, respectively (P=0.12). The AUCs of SA and the ADNEX model in postmenopausal women were 0.86 and 0.94, respectively (P=0.60).
Conclusion
The ADNEX model offers excellent discrimination between benign and malignant ovarian tumors with similar sensitivity and specificity to SA in both premenopausal and postmenopausal Korean women.
Key Words: Ovarian neoplasms, Fertility preservation, Prediction model, Ultrasonography


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