Tumor biomarkers contribute to the diagnosis and clinical management of the O-RADS MRI risk stratification system for epithelial ovarian tumors.

IF 2.5 3区医学 Q3 ONCOLOGY

World Journal of Surgical Oncology Pub Date : 2025-01-04 DOI:10.1186/s12957-024-03648-3

Shengjie Xu, Weijian Gong, Xiyi Chen, Jiatong Wang, Yuan Zhu, Tao Zhang, Yun Gu, Jinxia Zheng, Juan Xu

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引用次数: 0

Abstract

Background: To assess the effectiveness of tumor biomarkers in distinguishing epithelial ovarian tumors (EOTs) and guiding clinical decisions across each Ovarian-Adnexal Reporting and Data System (O-RADS) MRI risk category, the aim is to prevent unnecessary surgeries for benign lesions, avoid delays in treating malignancies, and benefit individuals requiring fertility preservation or those intolerant to over-extensive surgery.

Methods: A total of 54 benign, 104 borderline, and 203 malignant EOTs (BeEOTs, BEOTs and MEOTs) were enrolled and retrospectively assigned risk scores. The role of tumor biomarkers in diagnosing and managing EOTs within each risk category was evaluated by combining receiver operating characteristic (ROC) curves with clinicopathological characteristics.

Results: A score of 3 was assigned to 66.67% of BeEOTs, 50.96% of BEOTs, and 13.80% of MEOTs, whereas cancer antigen 125 (CA125) ≥ 60.39 U/ml helped identify MEOTs with a low-risk time-intensity curve (TIC) for prompt surgical assessment. Only 3.7% of the BeEOTs were classified as O-RADS MRI 4/5, whereas 48.08% and 86.2% of the BEOTs and MEOTs were classified, respectively. Overall, EOTs with a score of 4/5 are candidates for semi-elective surgery owing to the low probability of benign lesions. For EOTs with a ROMA index less than 20.14% (premenopausal) or 29.9% (postmenopausal), minimally invasive surgery is recommended for diagnostic and therapeutic purposes. Comprehensive staging or cytoreductive surgery is recommended for the remaining patients, especially when fertility preservation is not a priority.

Conclusions: The O-RADS MRI primarily differentiates BeEOTs with risk scores of 2/4/5 from BEOTs/MEOTs, while tumor biomarkers further enhance the diagnosis and clinical management of EOTs with scores of 3/4/5. Future studies should focus on multi-center, prospective studies with larger sample sizes to validate and refine the integration of O-RADS MRI with tumor biomarkers.

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肿瘤生物标志物有助于上皮性卵巢肿瘤 O-RADS MRI 风险分层系统的诊断和临床管理。

背景：为了评估肿瘤生物标志物在区分卵巢上皮性肿瘤（EOTs）的有效性，并指导每个卵巢-附件报告和数据系统（O-RADS） MRI风险类别的临床决策，目的是防止良性病变的不必要手术，避免治疗恶性肿瘤的延误，并使需要保留生育能力或不耐受过度手术的个体受益。方法：共纳入54例良性、104例交界性和203例恶性EOTs (BeEOTs、BEOTs和MEOTs)，并回顾性地进行风险评分。通过将受试者工作特征（ROC）曲线与临床病理特征相结合，评估肿瘤生物标志物在每个风险类别中诊断和管理eot中的作用。结果：66.67%的BEOTs、50.96%的BEOTs和13.80%的MEOTs评分为3分，而癌症抗原125 (CA125)≥60.39 U/ml有助于通过低风险时间-强度曲线（TIC）识别MEOTs，以便及时进行手术评估。仅3.7%的BEOTs被归类为O-RADS MRI 4/5级，而BEOTs和MEOTs的分类率分别为48.08%和86.2%。总体而言，由于良性病变的可能性较低，得分为4/5的EOTs可以进行半选择性手术。对于ROMA指数低于20.14%（绝经前）或29.9%（绝经后）的EOTs，建议进行微创手术进行诊断和治疗。对于剩余的患者，建议进行全面分期或细胞减少手术，特别是当保留生育能力不是优先考虑的时候。结论：O-RADS MRI主要区分风险评分为2/4/5分的BEOTs与BEOTs/MEOTs，而肿瘤生物标志物进一步增强了对评分为3/4/5分的BEOTs的诊断和临床管理。未来的研究应侧重于多中心、更大样本量的前瞻性研究，以验证和完善O-RADS MRI与肿瘤生物标志物的整合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Surgical Oncology ONCOLOGY-SURGERY

CiteScore

4.70

自引率

15.60%

发文量

362

审稿时长

3 months

期刊介绍： World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.