4种恶性风险指数评判卵巢肿瘤良恶性的价值  

The value of four malignant risk indexes in judging benign and malignant ovarian tumors

作　　者：马士红 李晓琴[1] 施燕芸[1] Ma Shihong;Li Xiaoqin;Shi Yanyun(Changzhou Second People's Hospital,Changzhou 213003,Jiangsu)

机构地区：[1]常州市第二人民医院,江苏常州213003

出　　处：《常州实用医学》2020年第4期211-215,共5页CHANGZHOU PRACTICAL MEDICINE

摘　　要：目的分析4种恶性风险指数(Risk Of Malignancy Index,RMI)评判卵巢肿瘤良恶性的价值。方法回顾分析200例卵巢肿瘤患者的术前CA125水平、绝经状态,超声分数、肿瘤大小以及术后病理等资料,采用不同的计算方法(RMI1、RMI12、RMI3、RMI4)计算卵巢肿瘤的恶性风险指数,并进行良恶性判定,结果与病理对照,评估这4种恶性风险指数对卵巢恶性肿瘤诊断的敏感性、特异性、阳性及阴性预测值。结果4种恶性风险指数评估卵巢肿瘤良恶性均比绝经状态,血清CA125水平和超声检查结果更可靠。4种RMI比较存在显著性差异(P<0.05),进行两两比较,发现RMI1与RMI2之间存在显著性差异(P<0.05)。在界值100时,RMI1的敏感性、特异性分别为77.50%、94.37%,RMI2的敏感性、特异性分别为82.50%、91.87%。RMI1、RMI2、RMI3(界值100)、RMI4(界值200)的阳性预测值77.5%、71.7%、74.4%、75.0%,高于原始界值的阳性预测值,且均具有高度特异性,分别为94.37%,91.87%、93.12%和93.12%。结论4种恶性风险指数对卵巢肿瘤的良恶性诊断均有较高的特异性和阳性预测值,改良后的RMI2较RMI1更精准。Objective To analyze the value of four risk of malignancy indexes(Risk Of Ma­lignancy Index,RMI)in judging benign and malignant ovarian tumors.Methods To retrospective­ly analyze the preoperative CA125 level,menopausal status,ultrasound score,tumor size,and postoperative pathology data of 200 patients with ovarian tumors,and use different calculation methods(RMI1,RMI2,RMI3,RMI4)to calculate the malignant risk index of ovarian tumors.The results were compared with pathology to evaluate the sensitivity,specificity,positive and neg­ative predictive value of these four malignant risk indexes for the diagnosis of ovarian malignant tumors.Results The four malignant risk indexes are more reliable than menopausal status,serum CA125 levels and ultrasound results in evaluating benign and malignant ovarian tumors.There are significant differences between the four RMIs(P<0.05).The pairwise comparisons show that there are significant differences between RMI1 and RMI2(P<0.05).At the cutoff value of 100,the sensitivity and specificity of RMI1 were 77.50%and 94.37%,respectively,and the sensitivity and specificity of RMI2 were 82.50%and 91.87%,respectively.The positive predictive values of RMI1,RMI2,RMI3(cut-off value 100),and RMI4(cut-off value 200)are 77.5%,71.7%,74.4%,and 75.0%,which are higher than the positive predictive value of the original cut-off val-ue.All of them are highly specificity,with 94.37%,91.87%,93.12%and 93.12%respectively.Conclusion The four malignant risk indexes have higher specificity and positive predictive value for the diagnosis of benign and malignant ovarian tumors.The improved RMI2 is more accurate than RMI1.

关 键 词：恶性风险指数 卵巢肿瘤 超声检查 CA125水平 绝经状态 评判 

分 类 号：R737.3[医药卫生—肿瘤]