卵巢-附件报告和数据系统(O-RADS)定性诊断卵巢肿瘤效能

Qualitative diagnostic efficacy of ovarian-adnexal reporting and data system(O-RADS)for ovarian tumors

目的观察卵巢-附件报告和数据系统(O-RADS)定性诊断卵巢肿瘤的效能。方法回顾性分析800例卵巢肿瘤患者的术前超声资料,以O-RADS对之分类。以病理结果为金标准,计算O-RADS定性诊断卵巢肿瘤的敏感度、特异度等;绘制受试者工作特征(ROC)曲线,获得曲线下面积(AUC)。结果共纳入800例患者、836个卵巢肿瘤病灶,病理诊断良性591个、恶性(含交界性)245个;包括617个上皮-间叶肿瘤(良性399个、恶性218个)、106个生殖细胞肿瘤(良性96个、恶性10个)及55个性索-间质肿瘤(良性40个、恶性15个)。以O-RADS>3类为最佳截断值,O-RADS分类鉴别卵巢良恶性肿瘤的敏感度为96.73%(237/245),特异度为86.29%(510/591),AUC为0.962;鉴别良、恶性上皮-间叶肿瘤、生殖细胞肿瘤及性索-间质肿瘤的敏感度分别为97.25%(212/218)、90.00%(9/10)及93.33%(14/15),特异度分别为84.96%(339/399)、86.46%(83/96)及85.00%(34/40),AUC分别为0.963、0.926及0.923。结论O-RADS可定性诊断卵巢肿瘤及鉴别诊断不同病理类型卵巢良、恶性肿瘤。

Objective To observe the qualitative diagnostic efficacy of the ovarian-adnexal reporting and data system(O-RADS)for ovarian tumors.Methods Data of preoperative ultrasound of 800 patients with ovarian tumors were retrospectively analyzed and classified with O-RADS.Taken the pathological results as the gold standards,the sensitivity and specificity of O-RADS for qualitative diagnosis of ovarian tumors were calculated.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was obtained.Results Totally 836 ovarian tumors in 800 patients were enrolled,591 were benign and 245 were malignant(including borderline)by pathological diagnosis,including 617 epithelial tumors(399 of benign,218 of malignant),106 germ cell tumors(96 of benign,10 of malignant)and 55 sex cord-stromal tumors(40 of benign,15 of malignant).Taken O-RADS>3 categories as the optimal cut-off value,the sensitivity of O-RADS classification in distinguishing benign and malignant ovarian tumors was 96.73%(237/245),the specificity was 86.29%(510/591),and the AUC was 0.962,while of O-RADS for differentiating benign and malignant epithelial tumors,germ cell tumors and sex cord-stromal tumors was 97.25%(212/218),90.00%(9/10)and 93.33%(14/15),with specificity of 84.96%(339/399),86.46%(83/96)and 85.00%(34/40)and AUC of 0.963,0.926 and 0.923,respectively.Conclusion O-RADS could qualitative diagnose ovarian tumors,also differentiate benign and malignant ovarian tumors of different pathological types.