两种卵巢癌恶性肿瘤风险指数的比较

Diagnosis of ovarian masses: comparison of two risk indices of malignancy

目的 比较基于血清癌抗原 12 5 (CA12 5 )、B超及月经状态的 2种恶性肿瘤风险指数 (RMI)对术前预测盆腔肿瘤良、恶性的价值。方法 我院 2 0 0 0年 6月～ 2 0 0 2年 6月诊断为盆腔肿瘤的手术患者 117例 ,其中恶性 5 2例 ,良性 6 5例 ,分别以术前血清CA12 5、B超、月经状态及RMI对肿瘤良、恶性进行预测 ,比较其敏感性、特异性及预测值。结果 与血清CA12 5、B超及月经状态比较 ,RMI能更有效地预测盆腔肿瘤的良、恶性。取值 80～ 12 0及 2 0 0、2 2 0时 ,RMI 2较RMI 1好 ;取值 10 0时RMI 2的敏感性和特异性分别达 76 .9%和90 .8%。RMI 2对Ⅱ期以上肿瘤的预测价值更高。结论 RMI是一种术前预测卵巢肿瘤良、恶性的简单、易用而有效的方法 ,尤其对晚期肿瘤有更高的敏感性。RMI 2较RMI

Objective To compare the preoperative predictive value of two risk indices of malignancy(RMI1 and RMI2) for ovarian masses based on serum CA125, B-mode ultrasound and menstruation status in differentiating malignant from benign pelvic masses. Methods 117 women with pelvic masses were admitted between June 2000 and June 2002 for surgical treatment. The sensitivity, specificity and positive predictive value of serum CA125 levels, ultrasonic features, and menstruation status were scored as RMI1 and RMI2; and compared with in malignant and benign ovarian tumors. Results The study confirmed that RMI was the more accurate one than each other item considered singly, reparatory in the diagnosis of pelvic malignancy. Taking the cut off values of 80～120, 200 and 220, RMI2 showed better result than RMI1. At a cut off value of 100, RMI2 gave a sensitivity of 76.9%, specificity of 90.8%, and positive predictive value of 87.0%. Conclusions RMI is able to identify malignant and benign pelvic masses efficaciously, especially for advanced malignancies, the predictive value of RMI2 is more reliable than that of RMI1.