borderline ovarian tumors and diagnostic dilemma of intraoperative diagnosis: could preoperative he4 assay and roma score assessment increase the frozen section accuracy? a multicenter case-control study

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2014
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Abstract
The aim of our study was to assess the value of a preoperative He4-serum-assay and ROMA-score assessment in improving the accuracy of frozen section histology in the diagnosis of borderline ovarian tumors (BOT). 113 women presenting with a unilateral ovarian mass diagnosed as serous/mucinous BOT at frozen-section-histology (FS) and/or confirmed on final pathology were recruited. Pathologists were informed of the results of preoperative clinical/instrumental assessment of all patients. For Group_A patients, additional information regarding He4, CA125, and ROMA score was available (in Group_B only CA125 was known). The comparison between Group A and Group B in terms of FS accuracy, demonstrated a consensual diagnosis in 62.8% versus 58.6% (P: n.s.), underdiagnosis in 25.6% versus 41.4% (P<0.05), and overdiagnosis in 11.6% versus 0% (P<0.01). Low FS diagnostic accuracy was associated with menopausal status (OR: 2.13), laparoscopic approach (OR: 2.18), mucinous histotype (OR: 2.23), low grading (OR: 1.30), and FIGO stage I (OR: 2.53). Ultrasound detection of papillae (OR: 0.29), septa (OR: 0.39), atypical vascularization (OR: 0.34), serum He4 assay (OR: 0.39), and ROMA score assessment (OR: 0.44) decreased the probability of underdiagnosis. A combined preoperative assessment through serum markers and ultrasonographic features may potentially reduce the risk of underdiagnosis of BOTs on FS while likely increasing the concomitant incidence of false-positive events.
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gizzo2014biomedborderline Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Salvatore Gizzo;Roberto Berretta;Stefania Di Gangi;Maria Guido;Giuliano Carlo Zanni;Ilaria Franceschetti;Michela Quaranta;Mario Plebani;Giovanni Battista Nardelli;Tito Silvio Patrelli
Journal spectrochimica acta - part a: molecular and biomolecular spectroscopy
Year 2014
DOI
10.1155/2014/803598
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