■手术仍然是怀疑卵巢癌的附件肿块的主要治疗选择。恶性率是,然而,只有10-15%的女性接受手术。这导致大量不必要的手术。建议采用基于监测的方法来形成手术转诊的基础。我们以前报道过MIA3G的临床表现,基于深度神经网络的算法,用于评估卵巢癌风险。在这项研究中,我们显示,MIA3G显着改善了存在附件肿块的女性的手术选择。
■MIA3G采用了7种血清生物标志物,患者年龄,和更年期状态。从12个存在附件肿块的中心的785名妇女(IQR:39-55岁)收集血清样本。计算该队列中所有受试者的MIA3G风险评分。在决定手术转诊时,医生无法获得MIA3G风险评分。将MIA3G用于手术转诊的表现与临床和手术结果进行比较。MIA3G还在一个独立的队列中进行了测试,该队列由14个研究地点的29名女性组成。在手术考虑之前,医生可以使用并使用MIA3G。
■与实际手术次数(n=207)相比,基于MIA3G评分的转诊将使手术减少62%(n=79).绝经前患者(77%)和≤55岁患者(70%)的降低幅度更大。此外,如果医师使用MIA3G评分进行手术选择,则恶性肿瘤预测将提高431%.MIA3G转诊的准确性为90.00%(CI87.89-92.11),而当不使用MIA3G评分时,仅观察到9.18%的准确性。这些结果在29名患者的独立多部位研究中得到了证实,其中医生在手术考虑中使用了MIA3G。在这个队列中,手术减少了87%。此外,MIA3G在该独立队列中的准确度和一致性均为96.55%.
■这些研究结果表明,MIA3G显著增强了医生对手术干预的决定,并改善了存在附件肿块的女性的恶性肿瘤预测。将MIA3G用作临床诊断工具可能有助于减少不必要的手术。
UNASSIGNED: Surgery remains the main treatment option for an adnexal mass suspicious of ovarian cancer. The malignancy rate is, however, only 10-15% in women undergoing surgery. This results in a high number of unnecessary surgeries. A surveillance-based approach is recommended to form the basis for surgical referrals. We have previously reported the clinical performance of MIA3G, a deep neural network-based algorithm, for assessing ovarian cancer risk. In this study, we show that MIA3G markedly improves the surgical selection for women presenting with adnexal masses.
UNASSIGNED: MIA3G employs seven serum biomarkers, patient age, and menopausal status. Serum samples were collected from 785 women (IQR: 39-55 years) across 12 centers that presented with adnexal masses. MIA3G risk scores were calculated for all subjects in this cohort. Physicians had no access to the MIA3G risk score when deciding upon a surgical referral. The performance of MIA3G for surgery referral was compared to clinical and surgical outcomes. MIA3G was also tested in an independent cohort comprising 29 women across 14 study sites, in which the physicians had access to and utilized MIA3G prior to surgical consideration.
UNASSIGNED: When compared to the actual number of surgeries (n = 207), referrals based on the MIA3G score would have reduced surgeries by 62% (n = 79). The reduction was higher in premenopausal patients (77%) and in patients ≤55 years old (70%). In addition, a 431% improvement in malignancy prediction would have been observed if physicians had utilized MIA3G scores for surgery selection. The accuracy of MIA3G referral was 90.00% (CI 87.89-92.11), while only 9.18% accuracy was observed when the MIA3G score was not used. These results were corroborated in an independent multi-site study of 29 patients in which the physicians utilized MIA3G in surgical consideration. The surgery reduction was 87% in this cohort. Moreover, the accuracy and concordance of MIA3G in this independent cohort were each 96.55%.
UNASSIGNED: These findings demonstrate that MIA3G markedly augments the physician\'s decisions for surgical intervention and improves malignancy prediction in women presenting with adnexal masses. MIA3G utilization as a clinical diagnostic tool might help reduce unnecessary surgeries.