三维超声联合ROMA指数在卵巢良恶性肿瘤鉴别中的应用价值

Application value of three-dimensional ultrasound combined with ROMA index in differentiating benign and malignant ovarian tumors

目的:探讨三维超声联合卵巢恶性肿瘤风险预测模型(ROMA)指数在卵巢良恶性肿瘤鉴别中的应用价值。方法:选取2017年10月至2018年10月在本院接受外科手术治疗的152例卵巢肿瘤患者作为受试对象,术后按照病理学检查结果分为卵巢良性肿瘤组84例、卵巢恶性肿瘤组68例。术前采用Voluson E8超声诊断仪进行三维超声检查;应用酶联免疫吸附试验(ELISA)检测血清人附睾蛋白4(HE4)、糖类抗原125(CA125)水平,由两者水平计算ROMA指数,并采用ROC曲线分析三者对卵巢良恶性肿瘤的诊断价值。结果:卵巢恶性肿瘤组患者三维超声诊断符合率明显低于卵巢良性肿瘤组(P<0.05)。卵巢恶性肿瘤组患者血清HE4、CA125水平及ROMA指数均显著高于卵巢良性肿瘤组(P<0.05)。血清HE4、CA125水平及ROMA指数诊断卵巢良恶性肿瘤的ROC曲线下面积分别为0.849、0.871、0.933,最佳截断值分别为132.46 pmol/L、150.27 U/mL、40.21%,且三维超声联合ROMA指数诊断灵敏度、特异度、准确度均高于单项指标检测。结论:应用三维超声联合ROMA指数能明显提高鉴别诊断卵巢良恶性肿瘤的灵敏度、特异度及准确度。

Objective:To explore the value of three-dimensional ultrasound combined with risk of ovarian malignancy algorithm(ROMA)index in differentiating benign and malignant ovarian tumors.Methods:From October 2017 to October 2018,152 patients with ovarian tumors who underwent surgical treatment in the hospital were selected as subjects.According to the results of pathological examination,they were divided into 84 cases in benign ovarian tumor group and 68 cases malignant ovarian tumor group.Voluson E8 ultrasound diagnostic instrument was used for three-dimensional ultrasound examination before operation.Levels of serum human epididymal protein 4(HE4)and carbohydrate antigen 125(CA125)were detected by enzyme-linked immunosorbent assay(ELISA).The ROMA index was calculated according to the their levels.The diagnostic value of the three methods in benign and malignant ovarian tumors were analyzed by ROC curve.Results:The coincidence rate of three-dimensional ultrasonography of patients in malignant ovarian tumor group was significantly lower than that in benign ovarian tumor group(P<0.05).Serum HE4,CA125 levels and ROMA index in patients with ovarian malignant tumors were significantly higher than those in patients with ovarian benign tumors(P<0.05).The areas under the ROC curve of serum HE4,CA125 levels and ROMA index in the diagnosis of benign and malignant ovarian tumors were 0.849,0.871 and 0.933 respectively.The best truncation values were 132.46 pmol/L,150.27 U/mL and 40.21% respectively.The diagnostic sensitivity,specificity and accuracy of three-dimensional ultrasound combined with ROMA index were higher than those of single index detections.Conclusion:Three-dimensional ultrasound combined with ROMA index can significantly improve the sensitivity,specificity and accuracy of differential diagnosis of ovarian benign and malignant tumors.