超声O-RADS 4亚分类联合CA125、HE4及RMI 4预测卵巢-附件肿块恶性风险  

O-RADS ultrasound 4 subclassification combined with CA125,HE4 and RMI 4 for predicting malignant risk of ovarian-adnexal masses

作　　者：刘鑫 周安艳 胡蓉[1] LIU Xin;ZHOU Anyan;HU Rong(Department of Obstetrics and Gynecology Ultrasound Diagnosis,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院妇产超声诊断科(新疆超声医学重点实验室),新疆乌鲁木齐830054

出　　处：《中国医学影像技术》2024年第10期1548-1551,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察超声卵巢-附件报告与数据系统(O-RADS)4亚分类联合糖类抗原125(CA125)、人附睾分泌蛋白4(HE4)及恶性肿瘤风险指数4(RMI 4)预测卵巢-附件肿块恶性风险的价值。方法回顾性分析142例O-RADS 4类卵巢-附件肿块患者资料,根据病理学结果将其分为良性组(n=104)及非良性组(包括交界性和恶性肿瘤,n=38)。以O-RADS 4a亚类、CA125≤35 U/ml、绝经前HE4≤70 pg/ml而绝经后HE4≤140 pg/ml或RMI 4总分≤450分为倾向良性,否则倾向恶性。纳入上述各参数构建预测O-RADS 4类卵巢-附件肿块恶性风险的logistic回归联合模型;绘制受试者工作特征曲线、计算曲线下面积(AUC),比较单一参数及联合模型的预测效能。结果非良性组最大径>10 cm肿块占比高于良性组(P<0.05);组间患者年龄及绝经状态差异均无统计学意义(P均>0.05)。以单一超声O-RADS 4亚分类、CA125水平、HE4水平及RMI 4评分预测卵巢-附件肿块恶性风险的AUC分别为0.891、0.751、0.701及0.800,联合模型的AUC为0.955,优于任意单一参数(P均<0.05)。结论评估超声O-RADS 4类卵巢-附件肿块亚分类并联合CA125水平、HE4水平及RMI 4评分可有效预测其恶性风险。Objective To observe the value of ovarian-adnexal reporting and data system(O-RADS)ultrasound 4 subcategory combined with carbohydrate antigen 125(CA125),human epididymis protein 4(HE4)and the risk of malignancy index 4(RMI 4)for predicting malignant risk of ovarian-adnexal masses.Methods Data of 142 patients with O-RADS ultrasound 4 ovarian-adnexal masses were retrospectively analyzed.According to pathological results,the patients were divided into benign group(n=104)and non-benign groups(n=38,including borderline and malignant tumors).Tumors with O-RADS subcategory 4a,CA125≤35 U/ml,premenopausal HE4≤70 pg/ml or postmenopausal HE4≤140 pg/ml,or RMI 4 total score≤450 were regarded as probably benign ones,otherwise as probably malignant ones.The above 4 parameters were included to establish a logistic regression combination model for predicting the risk of malignancy of ovarian-adnexal masses of O-RADS ultrasound 4.The receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy for predicting malignancy risk of each parameter alone and the combination model.Results The ratio of masses with a maximum diameter>10 cm in non-benign group was higher than that in benign group(P<0.05),while no significant difference of age nor menopausal status was found between groups(both P>0.05).The AUC of O-RADS ultrasound 4 subcategory,CA125 level,HE4 level and RMI 4 score alone for predicting the risk of malignancy of ovarian-adnexal masses was 0.891,0.751,0.701 and 0.800,respectively,while of the combination model was 0.955,higher than that of each parameter alone(all P<0.05).Conclusion Subcategory assessment of O-RADS ultrasound 4 ovarian-adnexal masses combined with CA125 level,HE4 level and RMI 4 score was efficient for predicting the risk of malignancy.

关 键 词：子宫附件疾病 病理学 超声检查 

分 类 号：R711.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]