超声O-RADS分类及GI-RADS分类联合血清CA125对卵巢良恶性肿瘤的鉴别诊断价值  

Ultrasonography O-RADS and GI-RADS combined with CA125 levels in differential diagnosis of benign and malignant ovarian tumors

作　　者：周芳芳 叶玲红[1] 陈方红[1] ZHOU Fangfang;YE Linghong;CHEN Fanghong(Department of Ultrasonography,Lishui Central Hospital,Lishui 323000,China)

机构地区：[1]丽水市中心医院超声医学科,323000

出　　处：《浙江医学》2023年第8期804-808,共5页Zhejiang Medical Journal

基　　金：浙江省基础公益研究计划项目(LGF20H180018)。

摘　　要：目的探讨超声卵巢附件报告及数据系统(O-RADS)及妇科影像报告与数据系统(GI-RADS)分类联合血清糖类抗原125(CA125)对卵巢良恶性肿瘤的鉴别诊断价值。方法选取丽水市中心医院2021年3月至2022年3月经手术病理检查证实的卵巢肿瘤患者242例,其中良性肿瘤184例,恶性肿瘤58例。由2位超声医师独立完成O-RADS及GI-RADS分类。以手术病理检查结果为金标准,分析超声O-RADS及GI-RADS分类联合血清CA125对卵巢良恶性肿瘤的鉴别诊断价值。结果242例患者的242个卵巢肿块中O-RADS分类2、3、4和5类的恶性肿瘤百分比分别为0、9.5%、17.3%和95.5%;GI-RADS分类2、3、4和5类的恶性肿瘤百分比分别为0、4.9%、20.0%和97.6%(均P<0.01)。O-RADS分类+CA125组合、GI-RADS分类+CA125组合以及3者组合诊断卵巢良恶性肿瘤的AUC分别为0.861、0.880和0.864,均高于单独使用O-RADS分类、GI-RADS分类和CA125的0.795、0.812和0.748(均P<0.05)。结论超声O-RADS、GI-RADS分类方法对鉴别卵巢良恶性肿瘤均具有较高的诊断价值,两种方法与血清CA125的组合(O-RADS分类+CA125和GI-RADS分类+CA125)比单独一种方法诊断卵巢恶性肿瘤具有更好的诊断效能,而O-RADS分类联合CA125既有较高的诊断效能,又能提供更为客观的诊断结果,具有在临床推广应用的价值。Objective To evaluate the application of ultrasound ovarian-adnexal reporting and data system(O-RADS)and gynecologic imaging reporting and data system(GI-RADS)combined with serum carbohydrate antigen125(CA125)levels for the differential diagnosis of benign and malignant ovarian tumors.Methods A total of 242 patients with ovarian lesions confirmed by surgical pathology from March 2021 to March 2022 at Lishui Central Hospital were enrolled in the study,including 184 benign and 58 malignant cases.O-RADS and GI-RADS classifications were completed independently by two ultrasound physicians,and the diagnostic value of O-RADS and GI-RADS classifications combined with serum CA125 level was analyzed using surgical pathology results as the gold standard.Results The percentages of malignant tumors in O-RADS 2,3,4,and 5 were 0,9.5%,17.3%,and 95.5%,respectively,while in GI-RADS 2,3,4,and 5 were 0,4.9%,20.0%,and 97.6%,respectively(P<0.01).The areas under ROC curves(AUC)of the O-RADS+CA125,the GI-RADS+CA125,and O-RADS+GI-RADS+CA125 in diagnosing benign and malignant ovarian tumors were 0.861,0.880 and 0.864,respectively,which were higher than those of O-RADS,GI-RADS and CA125 alone(0.795,0.812,and 0.748,all P<0.05).Conclusion The O-RADS and GI-RADS classifications have high diagnostic value in distinguishing between benign and malignant ovarian tumors,and the combination of both methods with serum CA125 has better diagnostic efficiency than using a single method alone.

关 键 词：超声检查 卵巢肿瘤 卵巢附件报告及数据系统 妇科影像报告与数据系统 糖类抗原125 

分 类 号：R737.31[医药卫生—肿瘤] R445.1[医药卫生—临床医学]