卵巢-附件报告和数据系统与恶性风险指数鉴别卵巢肿瘤良恶性的对比研究  

Ovarian-adnexal reporting and data system and risk of malignancy index in differentiating benign and malignant ovarian tumors:a comparative study

作　　者：王荣玲 房世保[1] 孙咏梅[1] 刘岳航 唐婉晴 杨宗利[1] WANG Rongling;FANG Shibao;SUN Yongmei;LIU Yuehang;TANG Wanqing;YANG Zongli(Department of Abdominal Ultrasound,the Affiliated Hospital of Qingdao University,Shandong 266003,China)

机构地区：[1]青岛大学附属医院腹部超声科,山东省青岛市266003

出　　处：《临床超声医学杂志》2022年第5期338-343,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的比较卵巢-附件报告和数据系统(O-RADS)与恶性风险指数(RMI)鉴别卵巢肿瘤良恶性的诊断价值,探讨预测卵巢恶性肿瘤的独立危险因素。方法选取我院经病理证实的卵巢肿瘤431例,其中良性258例,恶性(含交界性)173例;应用O-RADS、RMI鉴别卵巢肿瘤良恶性,以病理结果为金标准,绘制受试者工作特征(ROC)曲线分析O-RADS与RMI鉴别卵巢肿瘤良恶性的诊断效能,并对其进行比较;对O-RADS及RMI所包含的临床资料及超声参数行单因素及多因素Logistic回归分析,筛选预测卵巢恶性肿瘤的独立危险因素。结果O-RADS>3类时,诊断卵巢肿瘤良恶性的敏感性、特异性、准确率、曲线下面积分别为93.1%,89.5%、91.0%、0.94,RMI诊断卵巢肿瘤良恶性的敏感性、特异性、准确率、曲线下面积分别为68.2%、91.9%、82.4%、0.80;两种方法的敏感性、准确率、曲线下面积比较差异均有统计学意义(均P<0.001),特异性比较差异均无统计学意义。单因素分析显示,良、恶性卵巢肿瘤患者年龄、是否绝经、血小板计数、血清癌抗原125、人附睾蛋白,以及肿块最大径、囊壁或分隔厚度、有实性成分、乳头状凸起、血流评分、腹水比较差异均有统计学意义(均P<0.001);多因素Logistic回归分析显示,肿块最大径、囊壁或分隔厚度≥3 cm、有实性成分、血流评分3~4分、腹水是预测卵巢恶性肿瘤的独立危险因素(均P<0.01)。结论O-RADS鉴别卵巢肿瘤良恶性的诊断效能较RMI高,其中肿块最大径、囊壁或分隔厚度≥3 cm、有实性成分、血流评分3~4分、腹水是预测卵巢恶性肿瘤的独立危险因素。Objective and risk of malignancy index(RMI)for ovarian tumors,and to explore the independent risk factors for ovarian malignancy.Methods including 258 cases of benign lesions and 173 cases of malignant lesions(including borderline).O-RADS and RMI were used to differentiate benign and malignant ovarian tumors.Taking the pathological results as the golden standard,the receiver operating characteristic(ROC)curve was drawn to analyze and compare the diagnostic efficacy of O-RADS and RMI in differentiating benign and malignant ovarian tumors.The clinical data and ultrasonic parameters involved in O-RADS and RMI were analyzed by univariate and multivariate binary Logistic regression to identify the independent risk factors of ovarian malignancy.ResultsWhen the O-RADS>3,the sensitivity,specificity,accuracy,and the area under the ROC curve(AUC)for diagnosing benign and malignant ovarian tumors were 93.1%,89.5%,91.0%,and 0.94,respectively.The sensitivity,specificity,accuracy,and AUC of RMI for diagnosing benign and malignant ovarian tumors were 68.2%,91.9%,82.4%,and 0.80,respectively.There were significant differences in sensitivity,accuracy and AUC between the two methods(all P<0.001),but there was no significant difference in specificity.Univariate analysis showed that there were significant differences in age,menopause,platelet count,serum cancer antigen 125,human epididymal protein,the maximum diameter,the thickness of capsule wall or partition,solid components,papillary process,blood flow score and ascites between benign and malignant lesions(all P<0.001).Multivariate analysis showed that the maximum diameter,the thickness of the capsule wall or partition≥3 cm,solid components,blood flow score of 3~4 and ascites were independent risk factors of ovarian malignant tumors(all P<0.01).ConclusionThe diagnostic efficiency of O-RADS in differentiating benign and malignant ovarian tumors is higher than that of RMI.Among them,the maximum diameter,the thickness of capsule wall or partition≥3 cm,solid components,blood flow

关 键 词：超声检查 卵巢-附件报告和数据系统 恶性风险指数 卵巢肿瘤 良恶性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.31[医药卫生—诊断学]