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001-es BibID:	BIBFORM055604
Első szerző:	Erdődi Balázs (szülész-nőgyógyász szakorvosjelölt)
Cím:	The additive value of HE4 novel tumor marker to the IOTA simple rules in the management of ovarian masses / B. Erdődi, Z. Krasznai, E. Maka, L. Ördög, H. Balla, Z. Tóth, A. Jakab
Dátum:	2013
ISSN:	0960-7692
Megjegyzések:	Objectives: To determine the additive diagnostic value of HE4 tumor marker to the IOTA simple ultrasonographic (US) morpho- logic scoring system in the management of ovarian masses. Methods: Imaging properties of ovarian masses were evaluated preoperatively using the IOTA M and B rules. According to the US findings and the IOTA simple rules three groups were made: 1. B group: only B rules were applicable, 2. M group: only M rules were applicable, 3. E group: both M and B rules were applicable, expert's opinion needed. US results were matched with the preoperative CA125 and HE4 levels and the histological findings.Results: patients with ovarian masses were involved in the analysis (average: 42.10yrs, 13-83yrs). Among the 107 cases (50.95%, average: 38.39yrs, 13-78yrs) of the B group two turned to be malignant (1.87%). HE4 was elevated in 8, CA125 in 66, both of them in 3 cases. 74 patients fulfilled the requirements for M-rules (35.24%, average: 49.43yrs, 15-83yrs,), 42 proved to be malignant (56.76%). HE4 was increased in 34, CA125 in 55, both of them in 31 cases. E group was formed by 29 cases (13.81%, range: 16-81yrs, average: 37.10yrs) of which 5 showed malignancy (17.24%). Where the IOTA simple rules were applied US alone had a a sensitivity of 48.84% and a specificity of 76.64% which increased to 93.40% adding HE4 evaluation to the diagnostic algorithm. PPV also increased from 0.56 to 0.79 in those cases where HE4 was used together with US. Pattern recognition showed a NPV of 0.92 and a PPV of 0.26 which was raised to 1.0 as HE4 was used additionally. Specicity of combining pattern recognition and HE4 evaluation proved to be 100% in this study.Conclusions: IOTA simple rules can be used effectively to discrim- inate between benign and malignant ovarian masses in more than 85% of the cases. Masses with complex morphology often need pattern recognition which can call for other methods increasing both the predictive values and specificity of the method. HE4 can be used effectively to increase the specificity of the diagnostic ability of US.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idézhető absztrakt gynecology ultrasound ovarian pathology IOTA
Megjelenés:	Ultrasound in Obstetrics & Gynecology. - 42 : S1 (2013), p. 27. -
További szerzők:	Krasznai Zoárd Tibor (1973-) (szülész-nőgyógyász, gyermeknőgyógyász) Maka Eszter (1988-) (szülész-nőgyógyász rezidens) Ördög Lilla Balla Heidi Tóth Zoltán (1948-) (szülész-nőgyógyász, humángenetikus) Jakab Attila (1964-) (szülész-nőgyógyász, endokrinológus)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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