O-RADS分类联合血清CA125诊断卵巢恶性肿瘤的临床价值分析

Clinical value of O-RADS classification combined with serum CA125 in the diagnosis of malignant ovarian tumors

目的:探究卵巢-附件影像报告及数据系统(Ovarian-Adnexal Reporting and Data System,O-RADS)分类在鉴别卵巢肿瘤良恶性方面的诊断性能,并评估O-RADS分类联合血清糖类抗原(carbohydrate antigen,CA)125在鉴别卵巢肿瘤良恶性中的临床价值。方法:回顾并分析445例卵巢肿瘤的病理学检查结果及临床资料。根据O-RADS分类标准进行分类,测定血清CA125的水平,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,计算灵敏度、特异度、阳性预测值、阴性预测值。结果:445例卵巢肿瘤中,良性266例,恶性179例。一般临床资料中,卵巢恶性肿瘤组的平均年龄、绝经后恶性肿瘤发生率、CA125水平、人附睾蛋白4(human epididymal protein 4,HE4)水平高于良性肿瘤组(P<0.001);与卵巢肿瘤相关的超声特征中,病变类别、外部轮廓、血流评分和腹水都与恶性肿瘤有关(P<0.001)。绝经前、后妇女O-RADS分类的灵敏度分别为91.3%、94.9%;绝经前、后妇女O-RADS分类联合CA125的灵敏度分别为98.8%、97.0%;绝经前、后妇女O-RADS分类联合CA125的灵敏度高于单独的O-RADS分类(P<0.05)。结论:O-RADS分类在卵巢肿瘤中具有较高的诊断性能,当O-RADS联合CA125诊断卵巢肿瘤时,灵敏度提高,有助于提高卵巢肿瘤的检出率,具有较高的临床应用价值。

Objective:To assess the diagnostic performance of the Ovarian-Adnexal Reporting and Data System(O-RADS)classification and evaluate the clinical value of O-RADS classification combined with serum carbohydrate antigen(CA)125 in differentiating benign from malignant ovarian tumors.Methods:A retrospective analysis was performed on 445 cases including pathology and clinical data.Each case was assigned to an O-RADS category according to the criteria and the levels of serum CA125 were detected.The receiver operating characteristic(ROC)curve was drawn,and sensitivity,specificity,positive predictive value,negative predictive value was calculated.Results:Among 445 cases of ovarian tumors,266 cases were benign ovarian tumors and 179 cases were malignant ovarian tumors.In general clinical data,the average age,the incidence of postmenopausal malignant tumors,the level of CA125,and the level of human epididymal protein 4(HE4)in ovarian malignant tumors are higher than those in benign tumors(P<0.001).For the ultrasonographic characteristics of ovarian tumors,the lesion category,external contour,color score,and ascites were all related to the malignant tumor(P<0.001).The sensitivity of O-RADS classification in premenopausal and postmenopausal women was 91.3%and 94.9%,respectively.The sensitivity of O-RADS classification combined with CA125 in premenopausal and postmenopausal women was 98.8%and 97.0%,respectively.The sensitivity of O-RADS combined with CA125 in premenopausal and postmenopausal women is higher than O-RADS classification alone(P<0.05).Conclusion:O-RADS classification has high diagnostic performance in ovarian tumors.When O-RADS classification is combined with CA125 to diagnose ovarian tumors,the sensitivity is improved,which helps to improve the detection rate of ovarian tumors and has high clinical application value.