Tumor biomarkers contribute to the diagnosis and clinical management of the O-RADS MRI risk stratification system for epithelial ovarian tumors
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, avoi...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-024-03648-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841559373816528896 |
|---|---|
| author | Shengjie Xu Weijian Gong Xiyi Chen Jiatong Wang Yuan Zhu Tao Zhang Yun Gu Jinxia Zheng Juan Xu |
| author_facet | Shengjie Xu Weijian Gong Xiyi Chen Jiatong Wang Yuan Zhu Tao Zhang Yun Gu Jinxia Zheng Juan Xu |
| author_sort | Shengjie Xu |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-89454c1bc3c64731ace55251dfa210ee |
| institution | Kabale University |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-89454c1bc3c64731ace55251dfa210ee2025-01-05T12:32:15ZengBMCWorld Journal of Surgical Oncology1477-78192025-01-012311910.1186/s12957-024-03648-3Tumor biomarkers contribute to the diagnosis and clinical management of the O-RADS MRI risk stratification system for epithelial ovarian tumorsShengjie Xu0Weijian Gong1Xiyi Chen2Jiatong Wang3Yuan Zhu4Tao Zhang5Yun Gu6Jinxia Zheng7Juan Xu8Department of Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare HospitalDepartment of Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare HospitalDepartment of Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare HospitalDepartment of Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare HospitalDepartment of Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare HospitalDepartment of Radiology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare HospitalDepartment of Pathology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare HospitalDepartment of Radiology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare HospitalDepartment of Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare HospitalAbstract 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.https://doi.org/10.1186/s12957-024-03648-3ROMA indexCancer antigen 125O-RADS MRIEpithelial ovarian tumorClinical management |
| spellingShingle | Shengjie Xu Weijian Gong Xiyi Chen Jiatong Wang Yuan Zhu Tao Zhang Yun Gu Jinxia Zheng Juan Xu Tumor biomarkers contribute to the diagnosis and clinical management of the O-RADS MRI risk stratification system for epithelial ovarian tumors World Journal of Surgical Oncology ROMA index Cancer antigen 125 O-RADS MRI Epithelial ovarian tumor Clinical management |
| title | Tumor biomarkers contribute to the diagnosis and clinical management of the O-RADS MRI risk stratification system for epithelial ovarian tumors |
| title_full | Tumor biomarkers contribute to the diagnosis and clinical management of the O-RADS MRI risk stratification system for epithelial ovarian tumors |
| title_fullStr | Tumor biomarkers contribute to the diagnosis and clinical management of the O-RADS MRI risk stratification system for epithelial ovarian tumors |
| title_full_unstemmed | Tumor biomarkers contribute to the diagnosis and clinical management of the O-RADS MRI risk stratification system for epithelial ovarian tumors |
| title_short | Tumor biomarkers contribute to the diagnosis and clinical management of the O-RADS MRI risk stratification system for epithelial ovarian tumors |
| title_sort | tumor biomarkers contribute to the diagnosis and clinical management of the o rads mri risk stratification system for epithelial ovarian tumors |
| topic | ROMA index Cancer antigen 125 O-RADS MRI Epithelial ovarian tumor Clinical management |
| url | https://doi.org/10.1186/s12957-024-03648-3 |
| work_keys_str_mv | AT shengjiexu tumorbiomarkerscontributetothediagnosisandclinicalmanagementoftheoradsmririskstratificationsystemforepithelialovariantumors AT weijiangong tumorbiomarkerscontributetothediagnosisandclinicalmanagementoftheoradsmririskstratificationsystemforepithelialovariantumors AT xiyichen tumorbiomarkerscontributetothediagnosisandclinicalmanagementoftheoradsmririskstratificationsystemforepithelialovariantumors AT jiatongwang tumorbiomarkerscontributetothediagnosisandclinicalmanagementoftheoradsmririskstratificationsystemforepithelialovariantumors AT yuanzhu tumorbiomarkerscontributetothediagnosisandclinicalmanagementoftheoradsmririskstratificationsystemforepithelialovariantumors AT taozhang tumorbiomarkerscontributetothediagnosisandclinicalmanagementoftheoradsmririskstratificationsystemforepithelialovariantumors AT yungu tumorbiomarkerscontributetothediagnosisandclinicalmanagementoftheoradsmririskstratificationsystemforepithelialovariantumors AT jinxiazheng tumorbiomarkerscontributetothediagnosisandclinicalmanagementoftheoradsmririskstratificationsystemforepithelialovariantumors AT juanxu tumorbiomarkerscontributetothediagnosisandclinicalmanagementoftheoradsmririskstratificationsystemforepithelialovariantumors |