恶性风险指数-4在卵巢上皮性肿瘤中的诊断价值及影响因素  

Diagnostic value and influential factors of risk of malignancy index-4 in epithelial ovarian tumor

作　　者：胡鹏[1] 李菲[1] 莫凌昭[1] 

机构地区：[1]广西医科大学附属肿瘤医院妇瘤科,南宁530021

出　　处：《新医学》2016年第1期47-51,共5页Journal of New Medicine

摘　　要：目的评价恶性风险指数-4(RMI-4)在卵巢上皮性肿瘤中的诊断价值,分析影响RMI-4诊断效能的相关因素。方法收集150例接受手术治疗的卵巢上皮性肿瘤患者,分为良性、交界性、恶性3组,每组各50例。将交界性组纳入恶性组后,通过计算受试者工作特征-曲线下面积(ROC-AUC),比较RMI-4、临床症状、妇科检查、超声检查、血清糖链抗原125(CA125)对判断良恶性卵巢上皮性肿瘤效能的优劣。比较RMI-4在鉴别良性组与交界性组(A组)、良性组与恶性组(B组)间敏感度、特异度、阳性预测值、阴性预测值、ROC-AUC的差异,分析交界性成分对RMI-4诊断卵巢上皮性肿瘤效能的影响。结果 RMI-4、临床症状、妇科检查、超声得分、血清CA125判断良恶性卵巢上皮性肿瘤的ROC-AUC分别为0.915、0.670、0.740、0.840、0.842,RMI-4的ROC-AUC大于其他指标(P均<0.01)。B组的敏感度、阴性预测值、约登指数、ROC-AUC均明显优于A组(P均<0.01)。结论相对于临床症状、妇科检查、超声检查、血清CA125等单一指标,RMI-4更能准确地于术前判断卵巢上皮性肿瘤的良恶性,而卵巢上皮性肿瘤交界性成分是影响其诊断效能的重要因素。Objective To evaluate the diagnostic value of risk of malignancy index-4 （RMI-4） in epithelial ovarian tumor and analyze the influential factors of diagnostic performance of RMI-4. Methods In total, 150 women with epithelial ovarian tumor undergoing surgical treatment were assigned into the benign, borderline and malignant tumor groups （n = 50 for each group）. After integrating the borderline group into the malignant group, the diagnostic performance of RMI-4, clinical symptom, pelvic and ultrasound examination and serum carbohydrate antigen 125 （ CA125 ） was evaluated by calculating the area under the receiver operating characteristic curves （ROC-AUC）. The sensitivity, specificity, positive and negative predictive values and ROC-AUC of RMI-4 in differential diagnosis of benign and borderline tumors （group A） , and benign and malignant tumors （group B） were statistically compared. The effect of borderline factors upon the significance of RMI-4 in the diagnosis of epithelial ovarian tumor was assessed. Results The ROC-AUC of RMI-4 was 0. 915, significantly higher compared with 0. 670, 0. 740, 0. 840 and 0. 842 for clinical symptom, pelvic exam- ination, ultrasound examination and serum CA125 （ all P 〈 0. 01 ）. The sensitivity, negative predictive value, Youden index and ROC-AUC in the group B were significantly higher than those in the group A（ all P 〈0. 01 ）. Conclusions Compared with clinical symptom, pelvic and ultrasound examination and CA125, RMI-4 yields higher accuracy in the differential diagnosis of benign and malignant tumors. Borderline ovarian tumor is a vital influential factor of the diagnostic performance of RMI-4 in epithelial ovarian tumor.

关 键 词：卵巢上皮性肿瘤 恶性风险指数 诊断效能 

分 类 号：R737.31[医药卫生—肿瘤]