下肢淋巴水肿功能,残疾和健康问卷与淋巴水肿生活质量问卷在继发性下肢淋巴水肿中的诊断价值

Diagnostic value of Lymphoedema Functioning,Disability and Health Questionnaire for Lower Limb Lymphoedema and Lymphoedema Quality of Life Questionnaire in secondary lower limb lymphoedema

目的 验证下肢淋巴水肿功能、残疾和健康问卷(Lymph-ICF-LL)和淋巴水肿生活量问卷(LYMQOL)的敏感度和特异度,探索两种问卷的最佳截断值。方法 收集妇科恶性肿瘤术后继发性下肢淋巴水肿病人62例,妇科恶性肿瘤术后未患淋巴水肿病人37例。采用Lymph-ICF-LL评分问卷和LYMQOL评分问卷对两组病人行问卷调查。采用Spearman检验评估两种问卷评分与下肢淋巴水肿指数(LEL指数)之间的相关性。采用受试者工作特征曲线(ROC)评估两种问卷的预测诊断效能。结果 相关分析表明,Lymph-ICF-LL评分与LEL指数呈正相关(r=0.478,P<0.05),LYMQOL评分与LEL指数呈正相关(r=0.346,P<0.05)。两种问卷对检测继发性下肢淋巴水肿都具有较高准确度、敏感性和特异性,Lymph-ICF-LL的预测ROC曲线下面积为0.926(P<0.05),最佳截断值是20.1分,敏感度为83.9%,特异度为91.9%;LYMQOL的预测ROC曲线下面积为0.883(P<0.05),最佳截断值是1.9分,敏感度为80.6%,特异度为83.8%。结论 Lymph-ICF-LL和LYMQOL对继发性下肢淋巴水肿诊断有较高的特异度和敏感度。两种问卷可以作为继发性下肢淋巴水肿诊断方法之一。

Objective To study the sensitivity and specificity of Lymphoedema Functioning,Disability and Health Questionnaire for Lower Limb Lymphoedema(Lymph ICF-LL)and Lymphoedema Quality of Life Questionnaire(LYMQOL),and to explore the optimal cutoff score of the scales,in order to better identify secondary lower limb lymphoedema.Methods 62 patients with secondary lower limb lymphoedema and 37 patients without lymphedema after gynecological cancer operation was collected.Spearman test was used to evaluate the correlation between the scores of the two scales and the Lower Extremity Lymphedema Index(LEL index).Receiver operating characteristic(ROC)was used to evaluate the predictive diagnostic efficacy of the two scales.Results Correlation analysis showed that Lymph ICF-LL score was positively correlated with LEL index(r=0.478,P<0.05),and LYMQOL score was positively correlated with LEL index(r=0.346,P<0.05).Both scales had high accuracy,sensitivity and specificity in detecting secondary lymphedema of lower limbs.The area under the ROC curve of Lymph ICF-LL score in predicting was 0.926(P<0.05),the optimal cut-off value was 20.1 points,the sensitivity was 83.9%and the specificity was 91.9%.The area under the ROC curve of LYMQOL score in predicting was 0.883(P<0.05),the optimal cut-off value was 1.9 points,the sensitivity was 80.6%,and the specificity was 83.8%.Conclusion Lymph ICF-LL and LYMQOL have high specificity and sensitivity in the diagnosis of secondary lower limb lymphoedema.The two scales can be used as one of the diagnostic methods for secondary lower limb lymphoedema.