卵巢-附件报告和数据系统与ADNEX模型对卵巢-附件恶性病变诊断性能的对比研究  

Comparative study of Ovarian-Adnexal Ultrasound Reporting and Data System and the ADNEX Model in the diagnostic performance of ovarian-adnexal lesions

作　　者：魏雪晴 常璐晨 张坦 王丽 魏玺 Wei Xueqing;Chang Luchen;Zhang Tan;Wang Li;Wei Xi(Department of Ultrasound Diagnosis and Treatment,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Tianjin Clinical Research Center of Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院超声诊疗科,国家恶性肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市恶性肿瘤临床医学研究中心,天津300060

出　　处：《中华超声影像学杂志》2024年第3期229-235,共7页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金面上项目(82272008);天津市医学重点学科(专科)建设项目(TJYXZDXK-009A)。

摘　　要：目的比较及验证卵巢-附件报告和数据系统(O-RADS)与ADNEX模型对卵巢-附件恶性病变的诊断性能。方法回顾性纳入2020年12月至2022年12月于天津医科大学肿瘤医院接受卵巢-附件病变手术的患者275例,收集临床、病理及超声资料,应用卡方检验、ROC曲线等统计学方法分析O-RADS和ADNEX模型对卵巢-附件病变的诊断性能。结果275例患者中,良性127例(46.2%),恶性148例(53.8%)。基于O-RADS分层,46例(16.7%)为O-RADS 2类,50例(18.2%)为O-RADS 3类,66例(24.0%)为O-RADS 4类,113例(41.1%)为O-RADS 5类。O-RADS 2、O-RADS 3、O-RADS 4和O-RADS 5类的恶性率分别为0、0.08%、56.06%和94.70%。用卵巢-附件恶性病变ROC曲线分析O-RADS US和ADNEX模型的曲线下面积分别为0.93(95%CI=0.90~0.96)、0.94(95%CI=0.91~0.97)。以O-RADS≥4、ADNEX模型≥10%为截断值,两者敏感性差异无统计学意义(P=0.740),但O-RADS的特异性高于ADNEX模型(72.4%比56.7%,P=0.044)。结论以O-RADS≥4、ADNEX模型≥10%时两者对卵巢-附件恶性病变具有良好的诊断性能,O-RADS的特异性较高。Objective To compare and validate the diagnostic performance of the Ovarian-Adnexal Reporting and Data System(O-RADS)and the ADNEX model in the diagnosis of malignant ovarian-adnexal lesions.Methods A total of 275 patients who underwent surgery for ovarian-adnexal lesions at Tianjin Medical University Cancer Institute and Hospital from December 2020 to December 2022 were retrospectively collected.The clinical,pathological aud ultrasound dates of the patients were collected.Statistical methods,including chi-square tests and ROC curve analysis,were employed to assess the diagnostic performance of O-RADS and the ADNEX model for ovarian-adnexal lesions.Results Among the 275 patients included in this study,127(46.2%)had benign lesions,and 148(53.8%)had malignant lesions.Based on the O-RADS classification,46 cases(16.7%)were O-RADS 2,50 cases(18.2%)were O-RADS 3,66 cases(24.0%)were O-RADS 4,and 113 cases(41.1%)were O-RADS 5.The malignancy rates for O-RADS 2,O-RADS 3,O-RADS 4,and O-RADS 5 were 0%,0.08%,56.06%,and 94.7%,respectively.ROC curve analysis for malignant ovarian-adnexal lesions yielded an area under ROC curve of 0.93(95%CI=0.90-0.96)for O-RADS and 0.94(95%CI=0.91-0.97)for the ADNEX model.Using O-RADS≥4 and ADNEX model≥10%as cutoff values,there was no significant difference in sensitivity between the two methods(P=0.740),but O-RADS exhibited higher specificity compared to the ADNEX model(72.4%vs 56.7%,P=0.044).Conclusions When O-RADS≥4 and the ADNEX model≥10%are used as cutoff values,both methods demonstrate excellent diagnostic performance for malignant ovarian-adnexal lesions,with O-RADS exhibiting higher specificity.

关 键 词：超声检查 卵巢-附件疾病 卵巢-附件报告和数据系统 ADNEX 

分 类 号：R737.3[医药卫生—肿瘤] R445.1[医药卫生—临床医学]