IOTA简易标准联合RI及CA125对卵巢肿瘤定性诊断临床价值

The clinical value of IOTA simple criteria combined with RI and CA125 in qualitative diagnosis of ovarian tumors

目的探讨国际卵巢肿瘤分析组织(IOTA)简易标准及其联合血流阻力指数RI及CA125对卵巢肿瘤的病理定性诊断价值。方法选取在我院诊治的138例卵巢肿瘤患者(共计152个卵巢肿瘤病例)作为观察对象。所有病例均进行超声检查并应用IOTA简易标准进行评定,不确定类型联合RI及CA125辅助诊断,最终诊断结果与术后病理结果对照分析。结果 IOTA简易标准可用于定性诊断的有123例,不确定类型29例(19.1%)。123例可适用IOTA简易标准的病例中,诊断的灵敏度为95.7%,特异性为94.7%,准确度为95.1%,,阳性预测值为91.8%,阴性预测值为97.3%。由于不确定类型占19.1%,IOTA简易标准在本组病例中的灵敏度、特异性分别为73.7%、79.1%,而联合RI及CA125诊断的灵敏度为88.5%,特异性为92.3%,准确度为90.7%,阳性预测值为88.5%,阴性预测值为92.3%。结论 IOTA简易标准可用于卵巢肿瘤定性诊断,并且简便高效,特别适用于缺乏经验的超声医生对其作出诊断,但不适用于所有卵巢肿瘤,无法适用此标准的患者可联合RI及CA125辅助诊断,以提高诊断效能。

Objective To investigate the qualitative diagnostic value of IOTA simple criteria and its combined blood flow resistance index RI and CA125 on pathological diagnosis of ovarian tumors. Methods 138 patients with ovarian tumors who were treated in our hospital were selected as the research objects（a total of 152 ovarian tumor cases）. All cases were ultrasonically examined and assessed using the IOTA simple criteria. Uncertain type combined with RI and CA125 was used for auxiliary diagnosis. The results of the final diagnosis were compared with the pathological results. Results IOTA simple criteria can be used for qualitative diagnosis of 123 cases in which 29 cases were Uncertain type. In the 123 cases for which the IOTA simple criteria could be applied,diagnostic sensitivity was 95. 7%,specificity was 94. 7%,accuracy was 95. 1%,positive predictive value was91. 8%,negative predictive value was 97. 3%. Due to uncertainty type accounted for 19. 1%,the sensitivity and specificity of IOTA simple criteria were 73. 7% and 79. 1% in all cases. While combined with RI and CA125,the diagnostic sensitivity was88. 5%,specificity was 92. 3%,accuracy was 90. 7%,positive predictive value was 88. 5%,negative predictive value was92. 3%. Conclusion IOTA simple criteria can be used for qualitative diagnosis of ovarian tumors,which is simple and efficient,especially for inexperienced ultrasound doctor to make a diagnosis,but not suitable to all tumors. Patients who are unable to aplly this criteria can be combined with RI and CA125 for diagnosis so as to improve diagnostic performance.