External Validation of the Assessment of Different NEoplasias in the adneXa Model Performance in Evaluating the Risk of Ovarian Carcinoma Before Surgery in China: A Tertiary Center Study.

Abstract

The Assessment of Different NEoplasias in the adneXa (ADNEX) model was developed by the International Ovarian Tumor Analysis group to assess the risk of an ovarian mass being malignant. This study aimed to externally validate the ADNEX model performance in a tertiary center in China. This retrospective, single-center university hospital study assessed the model diagnostic accuracy. All patients were examined by transvaginal ultrasonography, and serum CA125 levels were measured. Moreover, clinicopathological information was collected. The diagnostic performance of the ADNEX model was calculated with and without CA125 as a predictor. We retrieved data of 335 patients, of which 53 were excluded based on the exclusion criteria. Of the included 282 patients, 178 (63.1%) had benign tumors, and 104 (36.9%) had malignant tumors. When CA125 was factored in, the area under the receiver operating characteristic curve (AUC) for the distinction between benign and malignant tumors was 0.93 (95% confidence interval [CI], 0.90-0.96), whereas it was 0.91 (95% CI, 0.88-0.95) without CA125. The concordance between the predicted risk of malignancy and the proportion of observed malignancies was well demonstrated by the calibration plots. The proper performance of the ADNEX model was verified externally in a tertiary center in China, showing a good distinction between tumour subtypes. Our findings suggest the ADNEX model is a valuable tool in clinical practice and may help in managing patients with adnexal masses.