A clinical scoring system for the diagnosis of adenomyosis.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Muhammet Yıldırır, Hakan Aytan, Hüseyin Durukan, İclal Gürses
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引用次数: 2

Abstract

Objective: To develop a scoring system using clinical evaluation methods to predict the presence of adenomyosis.

Materials and methods: A cohort of 232 patients who underwent hysterectomy for benign gynecologic disorders was prospectively enrolled. A detailed anamnesis was obtained and physical/pelvic examinations with trans-vaginal ultrasound imaging were performed one day before the hysterectomy. The diagnosis of adenomyosis was based on histopathologic examination. Findings were compared between patients with (n=55) and without (n=166) adenomyosis. Factors associated with adenomyosis were assessed with regression analysis and odds ratios (OR) were calculated. The variables found to be significant were chosen for the scoring system. Receiver operating characteristic analysis was carried out to find the cut-off values for these variables.

Results: Number of parity, dyspareunia and dysmenorrhea visual analogue scale (VAS) scores, age of menarche, presence of uterine tenderness and detection of heterogeneous myometrium and myometrial cysts during ultrasonography were found to be the significant parameters. OR for the presence of myometrial heterogeneity, myometrial cysts, uterine tenderness were 27.2, 3.6 and 9.3 respectively. Cut-off values were calculated; 3 for parity (OR=2.8), 13-years for menarche (OR=1.6), 2 for dyspareunia VAS scores (OR=1.9) and 4 for dysmenorrhea VAS scores (OR=1.2). The total sum of maximum OR that a patient can obtain was calculated as 47.6 and this value was assumed to predict the presence of adenomyosis 100%. The multiplication of the sum of the OR in a patient by 2.1 (100/47.2) was found to have a predictive ability for the presence of adenomyosis.

Conclusion: A scoring system is developed to predict adenomyosis non-invasively based on clinical evaluation.

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一种诊断子宫腺肌病的临床评分系统。
目的:建立一套应用临床评价方法预测子宫腺肌症的评分系统。材料和方法:前瞻性纳入232例因良性妇科疾病行子宫切除术的患者。在子宫切除术前一天,我们对患者进行了详细的记忆和经阴道超声检查。腺肌病的诊断是基于组织病理学检查。比较了55例(n=55)和166例(n=166)子宫腺肌症患者的结果。通过回归分析评估与子宫腺肌病相关的因素,并计算比值比(OR)。发现重要的变量被选择用于评分系统。为了找到这些变量的临界值,进行了接收机工作特性分析。结果:胎次、阴道痛、痛经视觉模拟评分(VAS)、初潮年龄、子宫压痛、超声检查有无异质子宫肌层及子宫肌层囊肿是影响子宫内膜病变的重要因素。存在子宫肌瘤异质性、子宫肌瘤囊肿、子宫压痛的OR分别为27.2、3.6和9.3。计算截止值;胎次3年(OR=2.8),初潮13年(OR=1.6),性交困难VAS评分2年(OR=1.9),痛经VAS评分4年(OR=1.2)。计算出患者可获得的最大OR的总和为47.6,并假设该值100%预测子宫腺肌症的存在。患者OR的总和乘以2.1(100/47.2)被发现具有预测子宫腺肌症存在的能力。结论:建立了一套基于临床评价的无创预测子宫腺肌症的评分系统。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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