[Investigating the predictive value of RMI and ROMA indices in patients with ovarian tumors of uncertain dignity]. / Az RMI- és a ROMA-index petefészekrákelõrejelzõ hatékonyságának vizsgálata adnextumorokban.

We were investigating the predictive value of RMI and ROMA indices in patients with ovarian tumors of uncertain dignity, in order to determine whether these methods are suitable for the early detection of ovarian malignancy. Our study included 162 patients treated at the Gynecological Department of the National Institute of Oncology (Budapest, Hungary). These patients were diagnosed with ovarian tumor of uncertain dignity, and were admitted to our Department with the purpose of gynecological surgery. Each of them had CA-125, HE4 blood tests and ultrasound scan in order to calculate RMI and ROMA indices and to study their effectiveness. In every case, the final type of surgery was determined by intraoperative frozen section examination results. Efficacy of RMI and ROMA indices was detected by the final histological examination taken from the same material that was sent for intraoperative frozen section. The sensitivity and specificity of RMI index was 82.0% and 85.1%, respectively, while ROMA index sensitivity and specificity was 88.5% and 72.3%. The results were better in postmenopausal women: RMI sensitivity had increased to 90.9% and specificity to 82.8%. ROMA index sensitivity reached 95.5% with a specificity of 60.7%. Thus premenopausal RMI sensitivity significantly decreased (58.8%), and specificity had surged (88.4%). In case of premenopausal ROMA results sensitivity had declined, though the results are much better than for RMI (70.6% vs. 58.8%), while specificity was 14% less than that of RMI (74.4% vs. 88.4%). According to our study, RMI and ROMA indices are good methods for identifying the dignity of malignant ovarian tumors. The sensitivity and specificity results are in accordance with international literature. Even though the premenopausal and postmenopausal values are different, RMI and ROMA tests complement each other and are excellent for predicting the dignity of a tumor. With the help of these indices 61 cases of malignancy were detected, which means that we have to operate only 3 patients in order to detect 1 case of malignancy.

[Endometrial cancer in a young woman taking oral contraceptives for a long time]. / Endometriumrák kialakulása fogamzásgátló gyógyszert szedó fiatal nóben.

The authors report a rare case of endometrial adenocarcinoma occurred in a 35-year old woman, who had taken oral contraceptives for 13 years. She came for consultation with irregular vaginal bleeding. Diagnostic curettage and histologic examination confirmed the diagnosis as endometrial adenocarcinoma. This case deserve special attention due to the rarity of the disease among young women. The authors emphasize the necessity of appropriate diagnostic work-up. In such cases histological examination is strongly recommended, since irregular vaginal bleeding might be caused by malignant disease even at young women using sequential oral contraceptives.