彩色超声判断实性浅表软组织肿物良恶性的ROC曲线分析

The ROC curve analysis of color Doppler ultrasound in differentiation of benign and malignant solid superficial soft tissue tumors

目的:应用受试者工作特征曲线(ROC曲线)评价彩色超声判断实性浅表软组织肿物良恶性的价值。方法:应用二维超声、彩色多普勒成像结合新近发展的三维成像、拓宽视野成像技术等观察92例实性浅表软组织肿物的超声表现并与手术及病理对照;对实性肿物的大小、边界、形态、内部均匀度、血流等超声指标进行半定量分级评分并把各分数相加,绘制综合以上各种超声表现判定实性浅表肿物良恶性的ROC曲线,同时计算Youden指数(YI,也称为正确诊断指数)确定最佳诊断点。结果:本组92例浅表软组织肿物超声检出率为100%,其中良性肿物72例,恶性肿物20例。ROC曲线下面积(Az)为0.994(P<0.001),Youden指数为10。结论:超声对浅表软组织肿物的诊断尤其是对良恶性判断有很高的准确度,从而对治疗方法起到非常重要的指导作用。

Objective： To investigate the value of color Doppler ultrasound in differentiation of benign and malignant solid superficial soft-tissue tumors using receiver operation characteristic curve （ROC curve）. Method： Ninty-two solid superficial soft-tissue tumors were studied using combination of two-dimensional and color Doppler ultrasound and compared with the pathologic results. The tumors were evaluated semi-quantitatively to get the ROC curve and the Youden index according to the tumors＇ size, margin, configuration, homogeneity and blood flow. Results： The color ultrasound demonstrated all the 92 tumors including 72 benign and 20 malignant ones. The area under the ROC curve was 0.994 （P〈0.001）, and the Youden index was 10. Conclusion： The color ultrasound is accurate in the differentiation of benign and malignant superficial soft tissue tumors, and plays a directive role in treatment planning.