IOTA超声简易标准诊断附件肿瘤良恶性的价值  

Evaluation of the IOTA simple rules in distinguishing between benign and malignant adnexal lesions

作　　者：田彩[1] 李海燕[1] 刘洁[1] 赵丽[1] 张建梅 温树彬[1] TIAN Cai;LI Haiyan;LIU Jie(Department of Gynecology,the Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院妇科,石家庄市050000 [2]河北省新河县人民医院产科

出　　处：《河北医药》2023年第22期3432-3436,共5页Hebei Medical Journal

基　　金：河北省医学科学重点研究课题计划(编号:20170594)。

摘　　要：目的探讨国际卵巢肿瘤分析(international ovarian tumour analysis,IOTA)简易标准的临床应用价值。方法回顾性分析2019年7月至2020年6月在河北医科大学第二医院妇产超声科就诊的198例超声提示存在附件肿物的患者,根据IOTA简易标准评估附件肿物的性质,并计算其敏感度、特异度等指标。结果根据IOTA简易标准评估良性患者113例(57.1%),恶性患者68例(34.3%),未分类患者17例(8.6%),适用率91.4%,IOTA诊断的敏感度为92.19%,特异度为92.31%,阳性预测值86.76%,阴性预测值95.58%,阳性似然比11.99%,阴性似然比0.08%,诊断准确率92.27%。与病理诊断一致性良好,Kappa值为0.833。结论简易标准评估附件肿物性质有较高的敏感性和特异性,对附件肿物性质的鉴别诊断有较高的临床应用价值,可以在临床工作中帮助超声医师做出判断。但是,简易标准不能评估所有卵巢肿物的性质,因此不确定的附件肿物需要高年资、经验丰富的超声医师帮助诊断。Objective To explore the clinical application value of the International Ovarian Tumor Analysis(IOTA)simple rules.Methods A total of 198 patients with adnexal masses found on ultrasound scans in the Department of Obstetrics and Gynecology Ultrasound,the Second Hospital of Hebei Medical University from July 2019 to June 2020 were retrospectively analyzed.The nature of adnexal masses was assessed according to the IOTA simple rules,and their sensitivity and specificity were calculated.Results Classified by the IOTA simple rules,there were 113(57.1%)benign cases,68(34.3%)malignant cases,and 17(8.6%)unclassified cases.The applicability rate,sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and accuracy of the IOTA simple rules in distinguishing between benign and malignant adnexal lesions were91.4%,92.19%,92.31%,86.76%,95.58%,11.99%,0.08%and 92.27%,respectively.It was highly agreed with the pathological diagnosis of adnexal masses,with the Kappa value of 0.833.Conclusion The IOTA simple rules have sensitivity and specificity in assessing the nature of adnexal masses,showing a high clinical application value for the differential diagnosis of adnexal masses.However,it is unable to assess the nature of all adnexal masses,and those uncertain ones still need to be diagnosed by senior,experienced ultrasound physicians.

关 键 词：附件肿物 超声 IOTA简易标准 

分 类 号：R737.31[医药卫生—肿瘤]