卵巢-附件影像报告和数据系统模型及联合CA125对卵巢肿瘤的诊断价值

Diagnostic Value of Ovarian-Adnexal Reporting and Data System Model and Combined with CA125 in Ovarian Tumor

目的探讨卵巢-附件影像报告和数据系统(O-RADS)模型及其联合糖类抗原125(CA125)对卵巢肿瘤的诊断价值。资料与方法回顾性分析2014年1月—2016年12月623例在华中科技大学同济医学院附属协和医院行附件包块手术患者的术前超声图像及临床资料。根据O-RADS 4中不同图像特征对应恶性风险指数差异大,将其分为A、B组,当评分4A且CA125<35 U/ml为良性,以病理诊断为“金标准”,比较单独O-RADS、CA125及O-RADS联合CA125诊断卵巢肿瘤的敏感度、特异度及受试者工作特征曲线下面积(AUC)。结果623例附件包块中,良性461例,恶性162例。O-RADS、CA125及联合诊断的敏感度分别为0.963、0.784,0.932,特异度分别为0.896、0.679和0.967,AUC分别为0.929、0.731和0.950。O-RADS单独评价与联合CA125诊断的敏感度差异无统计学意义(χ^(2)=1.552,P=0.213),但均优于CA125(χ^(2)=23.484、14.594,P均<0.001);联合诊断的特异度均高于单独O-RADS和CA125(χ^(2)=18.553、131.827,P均<0.001);三者AUC差异有统计学意义(联合诊断与O-RADS:Z=2.241,P=0.025;联合诊断与CA125:Z=11.212,P<0.001;O-RADS与CA125:Z=9.155,P<0.001)。结论ORADS联合CA125有助于提高卵巢肿瘤的诊断效能。

Purpose To investigate the diagnostic value of ovarian-adnexal reporting and data system(O-RADS)and combined carbohydrate antigen 125(CA125)in ovarian tumors.Materials and Methods Retrospective analysis of 623 cases with adnexal masses were confirmed by pathology in Union Hospital,Tongyi Medical College,Huazhong University of Science and Technology from January 2014 to December 2016,including the preoperative ultrasound images and clinical data.According to the malignant risk index varies greatly by different image features in O-RADS 4,they were divided into group A and B.When rated as 4A and CA125<35 U/ml,it was considered as benign.Pathology as the gold standard,the sensitivity,specificity and area under the curve(AUC)of O-RADS alone,CA125 and O-RADS combined with CA125 in the diagnosis of ovarian tumors were compared.Results Among 623 adnexal masses,461 were benign and 162 were malignant.The sensitivity of O-RADS,CA125 and combined models were 0.963,0.784 and 0.932,respectively;the specificity were 0.896,0.679 and 0.967,respectively;AUC were 0.929,0.731 and 0.950,respectively.There was no significant statistical difference of sensitivity between ORADS and combined CA125(χ^(2)=1.552,P=0.213),which were better than CA125(χ^(2)=23.484,14.594,P<0.001).The specificity of combined diagnosis was higher than that of O-RADS and CA125 alone(χ^(2)=18.553,131.827,P<0.001).There was significant difference in AUC among the three groups(combined diagnosis and O-RADS:Z=2.241,P=0.025;combined diagnosis and CA125:Z=11.212,P<0.001;O-RADS and CA125:Z=9.155,P<0.001).Conclusion O-RADS combined with CA125 can improve the diagnostic efficiency of ovarian tumors.