title: An Evaluation of the Applicability of the Risk of Malignancy Index for Adnexal Masses to Patients Seen at a Tertiary Hospital in Chandigarh, India.
abstract: BACKGROUND
  The discrimination between benign and malignant ovarian tumors is important considering to optimally plan for an appropriate surgical treatment.
  
  
  OBJECTIVE
  To determine the applicability of risk of malignancy index (RMI 2) for triaging patients with adnexal masses seen at tertiary care hospital in India.
  
  
  METHODS
  A retrospective case note review of patients with adnexal masses admitted in Gynecology department was done. RMI 2 was calculated for each patient using ultrasound score, menopausal status, and CA-125 levels (U/ml), and the value of RMI was compared to the histological diagnosis. Statistical analyses were performed using SPSS version 17.0 by descriptive and inferential statistics. The p value ≤0.05 was considered significant.
  
  
  RESULTS
  The Mean age and SD of hundred patients was 52.8 (10) years. Most of the patients were postmenopausal (68/100). A significant relationship of ovarian malignancy was found with increasing age, high ultrasound score, and high serum CA-125. The average value of CA-125 in benign and malignant ovarian tumor was 7.4 and 625, respectively. The RMI 2 at a cut-off value of 200 had a sensitivity of 96.7 %, specificity of 84 %, positive predictive value of 85.5 %, and negative predictive value of 67.7 %.
  
  
  CONCLUSIONS
  Our study confirms the applicability of RMI 2 >200 in diagnosing adnexal masses with high risk of malignancy. It can be easily introduced into clinical practice to facilitate the selection of the patients for surgery and also helpful in triaging patients to different treatment groups.
authors.affiliation: Department of Biochemistry, Himalayan Institute of Medical Sciences (HIMS), Jolly Grant, Dehradun, Uttarakhand India.
authors.forename: Sunny
authors.initials: S
authors.lastname: Chopra
authors.affiliation: Department of Biochemistry, GNEC, New Delhi, India.
authors.forename: Richa
authors.initials: R
authors.lastname: Vaishya
authors.affiliation: Department of Biochemistry, GMCH, Sector 32, Chandigarh, India.
authors.forename: Jasbinder
authors.initials: J
authors.lastname: Kaur
keywords: CA-125; Menopausal status; Ovarian cancer; Ultrasound score