IOTA SR与CA125、HE4、ROMA、RMI1、GI-RADS对卵巢良恶性肿瘤的诊断价值比较

Comparison of IOTA SR with CA125,HE4,ROMA,RMI1,GI-RADS in the diagnosis of benign and malignant ovarian tumors

目的探讨糖链多肽抗原125(CA125)、人附睾蛋白4(HE 4)、恶性肿瘤风险算法(ROMA)、恶性风险指数1(RMI1)、国际卵巢肿瘤分析简单规则(IOTA SR)、妇科影像报告与数据系统(GI-RADS)在卵巢良恶性肿瘤鉴别诊断中的价值。方法选取2019年7月至2020年7月于锦州医科大学附属第一医院83例行附件手术并经术后病理检查确诊的卵巢肿瘤患者,术前行常规检查、血清CA 125、血清HE 4及妇科超声检查,计算ROMA值、RMI1值,根据超声结果进行IOTA SR评分及GI-RADS评分。使用推荐的临界值计算每种方法的敏感度、特异度、阳性预测值、阴性预测值和约登指数,计量资料构建受试者工作特征(ROC)曲线及计算曲线下面积(AUC)。结果卵巢恶性肿瘤组与卵巢良性肿瘤组相比,血清CA125、血清HE4、ROMA、RMI1水平显著升高,且均具有统计学意义(P<0.05)。对于卵巢良恶性肿瘤诊断,敏感度:CA125>ROMA>IOTA SR>RMI1>HE4=GI-RADS,特异度:HE4>IOTA SR>ROMA>GI-RADS>RMI1>CA125,约登指数:IOTA SR>ROMA>HE4>RMI1=GI-RADS>CA125,AUC:ROMA>RMI1>HE4>CA125,CA125约登指数明显低于其余各组,且差异有统计学意义(P<0.05),IOTA SR、ROMA、HE4、RMI1、GI-RADS各组间约登指数有差异,但差异无统计学意义(P>0.05)。结论IOTA SR在卵巢良恶性肿瘤的鉴别诊断中有较高的敏感度与特异度,诊断效能较高。

Objective To study the value of the CA125,HE4,ROMA,RMI1,IOTA SR and GI-RADS in different ial diagnosis of benign and malignant ovarian tumors.Methods The total of 83 women operated because of ovarian tumor from July 2019 to July 2020 in the first affliated hospital of Jinzhou medical university were included.All masses were verified by histological examination.Preoperatively,patients were examined through transvaginal ultrasonography,CA125 and HE4 levels were measured.ROMA,RMI1,IOTA SR and GI-RADS were determined.Results The levels of serum CA125,serum HE4,ROMA and RMI1 in ovarian malignant tumor group were significantly higher than those in benign ovarian tumor group(P<0.05).In terms of the diagnosis of benign and malignant ovarian tumors,sensitivity:CA125>ROMA>IOTA SR>RMI1>HE4=GI-RADS;specificity:HE4>IOTA SR>ROMA>GI-RADS>RMI1>CA125;Yoden index:IOTA SR>ROMA>HE4>RMI1=GI-RADS>CA125;AUC:ROMA>RMI1>HE4>CA125.The Yoden index of CA125 was significantly lower than that of the other groups,and the difference was statistically significant(P<0.05).The Yoden index of IOTA SR,ROMA,HE4,RMI1 and GI-RADS showed differences,but the difference was not statistically significant(P>0.05).Conclusion IOTA SR has high sensitivity and specificity in the differential diagnosis of benign and malignant ovarian tumors,and its diagnostic efficacy is high.