| 摘要: |
| 目的：比较卵巢-附件超声报告和数据系统（O-RADS）、恶性风险指数（RMI）对卵巢肿瘤的诊断价值，探究预测卵巢恶性肿瘤的独立危险因素。
方法： 回顾性分析431例经病理证实的卵巢肿瘤的超声声像图，分别进行O-RADS 分类、恶性风险指数分析，以病理结果为金标准，绘制受试者工作特征曲线（ROC）曲线，计算敏感度、特异度、准确率、约登指数，比较两种方法的诊断效能，并对两者涉及因素进行单因素及多因素二元Logistic回归分析，获得预测卵巢恶性肿瘤的独立危险因素。
结果： ①431例卵巢肿瘤中，良性258例，恶性（含交界性）173例，一般临床资料中，患者年龄、是否绝经、血小板数量、血清癌抗原125（CA125）、人附睾蛋白（HE4）在两组间比较差异均有统计学意义（P＜0.001）。②O-RADS 分类、恶性风险指数（RMI）诊断卵巢肿瘤良恶性的敏感度分别为93.1%、68.2%，特异度分别为89.5%、91.9%，准确率分别为91.0%、82.4%，曲线下面积分别为0.94、0.80。两种分类方法的敏感度、准确率比较差异均有统计学意义（P＜0.001），曲线下面积（AUC）、特异度比较差异均无统计学意义（P＞0.05）。③单因素分析显示良性组与恶性组间肿块最大径、囊壁或分隔厚度、有实性成分、乳头状突起、血流评分、腹水比较，差异均有统计学意义（P＜0.001）；多因素分析显示肿块最大径、囊壁或分隔厚度（≥3cm）、有实性成分、血流评分（3-4分）、腹水是卵巢恶性肿瘤的独立危险因素（P＜0.001）。
结论： O-RADS 分类鉴别卵巢肿瘤良恶性的敏感度较高，具有一定的临床价值；肿块最大径、囊壁或分隔厚度（≥3cm）、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。 |
| 关键词: 超声检查 卵巢肿瘤 O-RADS 恶性风险指数 |
| DOI： |
| 投稿时间：2021-10-20修订日期：2021-11-15 |
| 基金项目: |
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| The diagnostic value and analysis of independent risk factors of O-RADS and malignant risk index for ovarian tumors |
| wangrongling,yang zong li,fang shi bao,sun yong mei,liu yue hang,tang wan qing |
| () |
| Abstract: |
| Objective: To compare the diagnostic value of ovarian-adnexal reporting and data system (O-RADS) and risk of malignant index (RMI) for ovarian tumors, and to explore the independent factors for prediction of malignant ovarian tumors.
Methods: Ultrasonographic data of 431 patients with ovarian tumors confirmed by pathology were analyzed retrospectively, and were classified using O-RADS, RMI respectively. Taking the pathological results as the gold standard, the receiver operating characteristic curve (ROC) was performed to calculate the sensitivity, specificity, accuracy and Youden index of O-RADS, RMI. The factors involved in the two methods were analyzed by single and multiple Logistic regression analysis to identify the predictive factors for malignant ovarian tumors.
Results: ①431 cases of ovarian tumors were benign and malignant (including borderline). The age，the number for postmenopausal cases, the platelet ,the serum CA125 level and the serum HE4 level in benign group were significantly lower than those in malignant group (P < 0.001).②The sensitivity of O-RADS and RMI in the diagnosis of benign and malignant ovarian tumors was 93.1% and 68.2%, the specificity was 89.5% and 91.9%, the accuracy was 91.0% and 82.4%, and the ROC was 0.94,0.80 respectively. The sensitivity and accuracy of O-RADS was higher than of RMI (P < 0.001), while the AUC ang specificity of 2 methods were no significant difference (P > 0.05). ③Single factors analysis showed that differences of maximum diameter of tumor, thickness of cyst wall or septum, solid component of tumor, papillary projection or nodule, color score and ascites were statistically significant between benign group and malignant group (P < 0.001). Multivariate analysis showed that maximum diameter, thickness of cyst wall or septum (≥ 3cm), solid component of tumor, color score (3-4) and ascites were independent risk factors for ovarian malignant tumor (P < 0.001).
Conclusion: O-RADS has high sensitivity than RMI in differentiating benign and malignant ovarian tumors, and has certain clinical value. The maximum diameter of the tumor, thick wall septum (≥ 3cm), solid components of tumor, color score (3-4) and ascites are independent risk factors for predicting ovarian malignant tumors. |
| Key words: ultrasonography ovarian tumor O-RADS risk of malignant index |
