Predictive value of Malignancy Risk Index(RMI) in adnexial masses

Ovarian malignancies are the second most frequently observed gynaecological malignancy. In female population, holds the fifth place in all types of malignancy and mortality rate, hence it has the highest mortality rate in gynaecological malignancy population(32). It causes more mortality when compared to all gynaecological malignancies all together(33).Jacobs et all, in 1990, developed a risk of malignancy index (RMI) depending on serum CA-125, menopausal status and ultrasonographic findings, which they recommended its use in benign-malign determination of adnexal masses. According to Jacobs et all, the benign-malign determination of adnexal masses by the usage of RMI, (for RMI=200, sensitivity and specificity 85,4% and 96,9% respectively), could be managed with higher sensitivity and specificity than USG and serum CA 125 individually and also indicated that the patients could be guided to suitable health centres for more suitable and effective surgical operations(8).We have studied our own patient group with the criteria formerly used by Jacobs et all in order to show RMI efficiency in benign-malign determination of adnexal masses. We have found that RMI can be useful in preoperative evaluation of women with adnexial masses, particularly postmenopausal women with epithelial overian carsinomasAccording to our findings, with accepting the RMI threshold value as 200, the calculated values revealed for sensitivity 55% , specificity 88,7% , PPV 55% and NPV 88,7%. As a result of our study, we think that RMI is not a sufficient method for diagnosing adnexal masses with high risk of malignancy and guidance to gynaecologic oncology centres for suitable and effective surgical operations.