早期卵巢癌经阴道彩色多普勒超声误诊患者特征及潜在因素分析

Characteristics and Potential Factors of Misdiagnosis by Transvaginal Color Doppler Sonography in Patients with Early Ovarian Cancer

目的分析早期卵巢癌经阴道彩色多普勒超声(TVCDS)误诊患者特征及潜在因素。方法回顾性选择2021年1月至2024年1月收治的160例疑似早期卵巢癌患者,术前行TVCDS,术后行病理学检查。根据术后病理学检查结果分为假阴性组与假阳性组,分析误诊患者特征。采用多因素Logistic回归分析早期卵巢癌诊断的影响因素。行潜在类别分析(LCA)比较影响因素分布特征差异。结果TVCDS发现卵巢癌阳性与阴性分别为127例、33例,病理学检查显示阳性与阴性分别为131例、29例,TVCDS与病理学检查阳性相符者104例,阴性相符者6例,假阳性23例,假阴性27例,共误诊50例。16例误诊为卵巢囊肿,11例误诊为子宫腺肌症,23例子宫内膜异位症误诊为卵巢癌。淋巴结转移、血流情况、包膜完整性、腹腔积液是早期卵巢癌诊断的影响因素(P<0.01)。LCA表明上述因素对早期卵巢癌误诊的影响具有异质性。结论早期卵巢癌特征不明显,易与卵巢囊肿、子宫内膜异位症等混淆,造成TVCDS误诊。淋巴结转移、血流情况、包膜完整性、腹腔积液是早期卵巢癌诊断的影响因素。

Objective To analyze the characteristics and potential factors of misdiagnosis by transvaginal color Doppler sonography(TVCDS)in patients with early ovarian cancer.Methods In total,160 patients with suspected early ovarian cancer were retrospective selected from January 2021 to January 2024,TVCDS were performed before surgery and pathological examination was performed after surgery.According to the results of pathological examination,the patients were divided into false negative group and false positive group,and the characteristics of misdiagnosed patients were analyzed.Multivariate Logistic regression analysis was used to analyze the factors affecting the diagnosis of early ovarian cancer.Latent class analysis(LCA)was used to compare the differences in the distribution characteristics of influencing factors.Results TVCDS showed 127 positive and 33 negative cases of ovarian cancer,respectively.Pathological examination showed 131 positive and 29 negative cases,respectively.There were 104 positive cases,6 negative cases,23 false positive cases and 27 false negative cases,and a total of 50 misdiagnosed cases.Sixteen patients were misdiagnosed with ovarian cysts,and 11 with adenomyosis,and 23 patients with endometriosis were misdiagnosed with ovarian cancer.Lymph node metastasis,blood flow,capsule integrity and abdominal fluid were influencing factors in the diagnosis of early ovarian cancer(P<0.01).LCA showed that the above factors had heterogeneous effects on misdiagnosis of early ovarian cancer.Conclusion The characteristics of early ovarian cancer are not obvious,and it is more likely to be confused with ovarian cyst and endometriosis,resulting in misdiagnosis of TVCDS.Lymph node metastasis,blood flow,capsule integrity and abdominal fluid are influencing factors in the diagnosis of early ovarian cancer.