To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from Se...To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from September 2014 to November 2016.Age,menopausal status,histopathology,the International Federation of Gynecology and Obstetrics(FIGO)stages,tumor biomarker levels,and detailed ultrasound reports of patients were collected.The area under the curve(AUC),sensitivity,and specificity of the bellow-mentioned predictors were analyzed using the receiver operating characteristic curve.Of the 719 patients,531 had benign lesions,119 had epithelial ovarian cancers(EOC),44 had borderline ovarian tumors(BOT),and 25 had non-EOC.AUCs and the sensitivity of cancer antigen 125(CAI25),human epididymis-specific protein 4(HE4),Risk of Ovarian Malignancy Algorithm(ROMA),Risk of Malignancy Index(RMI1),HE4 model,and Rajavithi-Ovarian Cancer Predictive Score(R-OPS)in the overall population were 0.792,0.854,0.856,0.872,0.893,0.852,and 70.2%,56.9%,69.1%,60.6%,77.1%,71.3%,respectively.For distinguishing EOC from benign tumors,the AUCs and sensitivity of the above mentioned predictors were 0.888,0.946,0.947,0.949,0.967,0.966,and 84.0%,79.8%,87.4%,84.9%,90.8%,89.1%,respectively.Their specificity in predicting benign diseases was 72.9%,94.4%,87.6%,95.9%,86.3%,90.8%,respectively.Therefore,we consider biomarkers in combination with ultrasound features may improve the diagnostic performance in distinguishing malignant from benign ovarian tumors.展开更多
目的观察卵巢-附件报告和数据系统超声2022版(O-RADS US v2022)及其联合恶性风险指数4(RMI4)鉴别附件良、恶性肿瘤的价值。方法回顾性分析126例手术病理诊断为附件肿瘤患者,根据O-RADS US v2022将1~3类归为良性病变、4~5类归为恶性病变,...目的观察卵巢-附件报告和数据系统超声2022版(O-RADS US v2022)及其联合恶性风险指数4(RMI4)鉴别附件良、恶性肿瘤的价值。方法回顾性分析126例手术病理诊断为附件肿瘤患者,根据O-RADS US v2022将1~3类归为良性病变、4~5类归为恶性病变,以450为RMI4分类的临界值,基于二者进行联合分类。以病理结果为金标准,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估单一O-RADS US v2022、RMI4及其联合鉴别附件良、恶性肿瘤的效能。结果126例附件肿瘤中,良性94例、恶性32例。O-RADS US v2022鉴别附件良、恶性肿瘤的敏感度、特异度、准确率及AUC分别为78.13%、80.85%和80.16%、0.795,RMI4分别为71.88%、84.04%和80.95%、0.780;二者联合的特异度及准确率(93.62%、92.06%)均高于单一O-RADS US v2022(χ^(2)=7.322、5.967,P=0.007、0.015)或RMI4(χ^(2)=4.625、5.331,P=0.032、0.021),而敏感度及AUC(87.50%、0.906)差异均无统计学意义(P均>0.05)。结论O-RADS US v2022能有效鉴别附件良、恶性肿瘤,联合RMI4可提高鉴别特异度及准确率。展开更多
目的探讨卵巢-附件超声报告和数据风险分层系统(O-RADS US)结合卵巢恶性肿瘤风险算法(ROMA)鉴别卵巢-附件肿瘤良恶性的价值。方法回顾性分析2021年6月至2023年5月于青岛市市立医院妇产科住院治疗的卵巢-附件肿瘤患者89例的临床资料。采...目的探讨卵巢-附件超声报告和数据风险分层系统(O-RADS US)结合卵巢恶性肿瘤风险算法(ROMA)鉴别卵巢-附件肿瘤良恶性的价值。方法回顾性分析2021年6月至2023年5月于青岛市市立医院妇产科住院治疗的卵巢-附件肿瘤患者89例的临床资料。采用经阴道超声观察病灶的大小、回声、形态、内部分隔及血流分布等超声特征,按照O-RADS US对病灶进行分类,并通过糖类抗原125(CA125)和人附睾蛋白4(HE4)表达水平计算ROMA值。采用受试者操作特征(ROC)曲线分析O-RADS US、ROMA及其联合诊断卵巢癌的效能。结果本研究共收集到93个病灶,卵巢癌病灶的最大径及ROMA值均高于良性病灶,差异有统计学意义(P<0.05)。O-RADS US分类为2、3、4、5类的病灶分别占21.5%(20/93)、26.9%(25/93)、33.3%(31/93)和18.3%(17/93);联合ROMA对O-RADS US分类进行校正,则O-RADS US分类为2、3、4、5类的病灶分别占34.4%(32/93)、29.0%(27/93)、14.0%(13/93)、22.6%(21/93)。联合ROMA后,O-RADS US 2、3、4类卵巢-附件病灶分别有4、6、9个升级为O-RADS US 3、4、5类;同样,O-RADS US 5、4、3类卵巢-附件病灶分别有5、20、16个降级为O-RADS US 4、3、2类。O-RADS US诊断卵巢癌的敏感度、特异度、准确度、曲线下面积分别为80.0%、75.3%、76.3%、0.861。ROMA诊断绝经前和绝经后患者卵巢癌的敏感度、特异度、准确度及曲线下面积分别为85.0%、82.2%、82.8%、0.876及90.0%、89.0%、89.2%、0.904。O-RADS US联合ROMA诊断卵巢癌的敏感度、特异度、准确度及曲线下面积分别为95.0%、91.8%、92.5%、0.926。以O-RADS US联合ROMA诊断卵巢癌的曲线下面积最大,其次是ROMA,差异有统计学意义(P<0.05)。结论O-RADS US分类系统可以有效识别卵巢癌,与ROMA联合应用,能够克服单独应用的不足,提高卵巢癌诊断的性能,减少不必要的穿刺活检。展开更多
Objective To evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass. Methods One hundred and ...Objective To evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass. Methods One hundred and forty women with pelvic masses, at age 30 of years or more were admitted to the Peking Union Medical College Hospital between January 1998 and June 1999. The sensitivity, specificity and positive predictive value of serum CA125 level, ultrasound findings and the menopausal status in diagnosis of ovarian cancer were evaluated separately or combined into the RMI. Results RMI was more accurate than any individual criterion in diagnosing cancer. Using an RMI cutoff level of 200 to indicate malignancy, the RMI derived from this data set gave a sensitivity of 87.3%, a specificity of 84.4%, and a positive predictive value of 82.1%. Conclusions RMI is able to correctly discriminate malignant from benign pelvic mass. It can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery.展开更多
Objective:To study the value of serum tumor markers, carbohydrate antigen 125 (CA125), human epididymis secretory protein 4 (HE4) and ovarian cancer risk factor (ROMA) index in elderly patients with ovarian cancer, so...Objective:To study the value of serum tumor markers, carbohydrate antigen 125 (CA125), human epididymis secretory protein 4 (HE4) and ovarian cancer risk factor (ROMA) index in elderly patients with ovarian cancer, so as to provide a choice for clinical diagnosis.Methods:A total of 110 cases of ovarian cancer treated in our hospital in December 2017-December 2015 were selected as malignant group. In addition, 120 cases of benign ovarian tumors in the same period were selected as the benign group, and 92 healthy women who came to the hospital for health examination were selected as the control group. Serum HE4, CA125 levels and positive rates were detected by microparticle enzyme immunochemiluminescence assay, and ROMA index values were combined to assess the risk of ovarian cancer.Results:Malignant group serum CA125, HE4 level and ROMA index were significantly higher than those in the benign group and the control group, the level of CA125 in positive group was higher than control group, but the difference in level of HE4 and ROMA index between benign group and control group was not statistically significant. The positive rates of serum CA125, HE4 and ROMA index in malignant group were 76.4%, 92.7%, 96.4%, which were significantly higher than those in benign group (28.3%, 18.3%, 15%). The negative predictive value, positive predictive value, specificity and sensitivity of CA125 were all lower than those of HE4. The negative predictive value, positive predictive value, specificity and sensitivity of the combined ROMA index were higher than those of single diagnosis.Conclusions: Serum CA125, HE4 and ROMA index in elderly patients with ovarian cancer are significantly higher than those in elderly patients with benign ovarian tumors and healthy women. The combined diagnosis is the highest, with Gao Min's high sensitivity and specificity, which can be popularized in clinical practice.展开更多
目的评价CA125、超声检查、恶性风险指数-3(risk of malignancy index,RMI-3)及恶性风险指数-4(RMI-4)对绝经后卵巢肿瘤的诊断价值。方法回顾性分析2008年1月至2010年2月复旦大学附属妇产科医院手术治疗的绝经后卵巢肿瘤患者186例,比较...目的评价CA125、超声检查、恶性风险指数-3(risk of malignancy index,RMI-3)及恶性风险指数-4(RMI-4)对绝经后卵巢肿瘤的诊断价值。方法回顾性分析2008年1月至2010年2月复旦大学附属妇产科医院手术治疗的绝经后卵巢肿瘤患者186例,比较超声检查、CA125水平及2种RMI对附件肿块良恶性判断的敏感性和特异性。结果 4种指标的敏感性分别为90.7%、54.9%、83.7%和84.9%,特异性分别为93.7%、78.9%、96.8%和93.7%,约登指数(Youden index,YI)分别为0.84、0.34、0.81和0.78。四者的诊断效能两两相比,差异均有统计学意义(P=0.00)。造成各指标假阴性的病例以上皮性肿瘤为主,造成假阳性的病例以性索间质肿瘤为主。结论本研究发现目前2种RMI对绝经后卵巢肿瘤诊断的敏感性及YI均低于血清CA125。鉴于绝经后卵巢肿瘤的特殊性,可能需进一步评估CA125在绝经后卵巢肿瘤中的重要性以提高RMI对其的诊断效能。展开更多
目的:研究卵巢恶性肿瘤患者发生静脉血栓栓塞症(venous thromboembolism,VTE)的危险因素。方法:回顾性分析2015年1月1日至2018年6月30日中山大学孙逸仙纪念医院妇科肿瘤专科收治的345例卵巢恶性肿瘤患者资料,其中31例发生VTE,314例未发...目的:研究卵巢恶性肿瘤患者发生静脉血栓栓塞症(venous thromboembolism,VTE)的危险因素。方法:回顾性分析2015年1月1日至2018年6月30日中山大学孙逸仙纪念医院妇科肿瘤专科收治的345例卵巢恶性肿瘤患者资料,其中31例发生VTE,314例未发生VTE。比较卵巢恶性肿瘤患者的年龄、身高、体质量、病理分期、病理类型、肿瘤标志物水平等,以研究卵巢恶性肿瘤患者发生静脉血栓的危险因素。结果:卵巢恶性肿瘤合并VTE组与无VTE组的年龄和手术病理分期差异有统计学意义(P<0.05);体质指数(body mass index,BMI)、病理类型的差异无统计学意义(P>0.05)。2组血肿瘤标志物(AFP、CEA、CA125、CA199、CA724、HE4)水平差异均无统计学意义(P>0.05)。Logistic分析提示手术病理分期是卵巢恶性肿瘤合并VTE的独立危险因素。结论:年龄和分期是卵巢恶性肿瘤合并VTE的危险因素,对年龄大以及肿瘤晚期的患者应重点预防和监测血栓的发生。展开更多
基金grants from Guangdong Science and Technology Department of China(No.2016A020215115)Science and Technology Bureau of Tianhe District,Guangzhou,Guangdong(No.201604KW010)Science and Technology Bureau of Huadu District,Guangzhou,Guangdong(No.HD15CXY006).
文摘To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from September 2014 to November 2016.Age,menopausal status,histopathology,the International Federation of Gynecology and Obstetrics(FIGO)stages,tumor biomarker levels,and detailed ultrasound reports of patients were collected.The area under the curve(AUC),sensitivity,and specificity of the bellow-mentioned predictors were analyzed using the receiver operating characteristic curve.Of the 719 patients,531 had benign lesions,119 had epithelial ovarian cancers(EOC),44 had borderline ovarian tumors(BOT),and 25 had non-EOC.AUCs and the sensitivity of cancer antigen 125(CAI25),human epididymis-specific protein 4(HE4),Risk of Ovarian Malignancy Algorithm(ROMA),Risk of Malignancy Index(RMI1),HE4 model,and Rajavithi-Ovarian Cancer Predictive Score(R-OPS)in the overall population were 0.792,0.854,0.856,0.872,0.893,0.852,and 70.2%,56.9%,69.1%,60.6%,77.1%,71.3%,respectively.For distinguishing EOC from benign tumors,the AUCs and sensitivity of the above mentioned predictors were 0.888,0.946,0.947,0.949,0.967,0.966,and 84.0%,79.8%,87.4%,84.9%,90.8%,89.1%,respectively.Their specificity in predicting benign diseases was 72.9%,94.4%,87.6%,95.9%,86.3%,90.8%,respectively.Therefore,we consider biomarkers in combination with ultrasound features may improve the diagnostic performance in distinguishing malignant from benign ovarian tumors.
文摘目的观察卵巢-附件报告和数据系统超声2022版(O-RADS US v2022)及其联合恶性风险指数4(RMI4)鉴别附件良、恶性肿瘤的价值。方法回顾性分析126例手术病理诊断为附件肿瘤患者,根据O-RADS US v2022将1~3类归为良性病变、4~5类归为恶性病变,以450为RMI4分类的临界值,基于二者进行联合分类。以病理结果为金标准,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估单一O-RADS US v2022、RMI4及其联合鉴别附件良、恶性肿瘤的效能。结果126例附件肿瘤中,良性94例、恶性32例。O-RADS US v2022鉴别附件良、恶性肿瘤的敏感度、特异度、准确率及AUC分别为78.13%、80.85%和80.16%、0.795,RMI4分别为71.88%、84.04%和80.95%、0.780;二者联合的特异度及准确率(93.62%、92.06%)均高于单一O-RADS US v2022(χ^(2)=7.322、5.967,P=0.007、0.015)或RMI4(χ^(2)=4.625、5.331,P=0.032、0.021),而敏感度及AUC(87.50%、0.906)差异均无统计学意义(P均>0.05)。结论O-RADS US v2022能有效鉴别附件良、恶性肿瘤,联合RMI4可提高鉴别特异度及准确率。
文摘目的探讨卵巢-附件超声报告和数据风险分层系统(O-RADS US)结合卵巢恶性肿瘤风险算法(ROMA)鉴别卵巢-附件肿瘤良恶性的价值。方法回顾性分析2021年6月至2023年5月于青岛市市立医院妇产科住院治疗的卵巢-附件肿瘤患者89例的临床资料。采用经阴道超声观察病灶的大小、回声、形态、内部分隔及血流分布等超声特征,按照O-RADS US对病灶进行分类,并通过糖类抗原125(CA125)和人附睾蛋白4(HE4)表达水平计算ROMA值。采用受试者操作特征(ROC)曲线分析O-RADS US、ROMA及其联合诊断卵巢癌的效能。结果本研究共收集到93个病灶,卵巢癌病灶的最大径及ROMA值均高于良性病灶,差异有统计学意义(P<0.05)。O-RADS US分类为2、3、4、5类的病灶分别占21.5%(20/93)、26.9%(25/93)、33.3%(31/93)和18.3%(17/93);联合ROMA对O-RADS US分类进行校正,则O-RADS US分类为2、3、4、5类的病灶分别占34.4%(32/93)、29.0%(27/93)、14.0%(13/93)、22.6%(21/93)。联合ROMA后,O-RADS US 2、3、4类卵巢-附件病灶分别有4、6、9个升级为O-RADS US 3、4、5类;同样,O-RADS US 5、4、3类卵巢-附件病灶分别有5、20、16个降级为O-RADS US 4、3、2类。O-RADS US诊断卵巢癌的敏感度、特异度、准确度、曲线下面积分别为80.0%、75.3%、76.3%、0.861。ROMA诊断绝经前和绝经后患者卵巢癌的敏感度、特异度、准确度及曲线下面积分别为85.0%、82.2%、82.8%、0.876及90.0%、89.0%、89.2%、0.904。O-RADS US联合ROMA诊断卵巢癌的敏感度、特异度、准确度及曲线下面积分别为95.0%、91.8%、92.5%、0.926。以O-RADS US联合ROMA诊断卵巢癌的曲线下面积最大,其次是ROMA,差异有统计学意义(P<0.05)。结论O-RADS US分类系统可以有效识别卵巢癌,与ROMA联合应用,能够克服单独应用的不足,提高卵巢癌诊断的性能,减少不必要的穿刺活检。
文摘Objective To evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass. Methods One hundred and forty women with pelvic masses, at age 30 of years or more were admitted to the Peking Union Medical College Hospital between January 1998 and June 1999. The sensitivity, specificity and positive predictive value of serum CA125 level, ultrasound findings and the menopausal status in diagnosis of ovarian cancer were evaluated separately or combined into the RMI. Results RMI was more accurate than any individual criterion in diagnosing cancer. Using an RMI cutoff level of 200 to indicate malignancy, the RMI derived from this data set gave a sensitivity of 87.3%, a specificity of 84.4%, and a positive predictive value of 82.1%. Conclusions RMI is able to correctly discriminate malignant from benign pelvic mass. It can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery.
文摘Objective:To study the value of serum tumor markers, carbohydrate antigen 125 (CA125), human epididymis secretory protein 4 (HE4) and ovarian cancer risk factor (ROMA) index in elderly patients with ovarian cancer, so as to provide a choice for clinical diagnosis.Methods:A total of 110 cases of ovarian cancer treated in our hospital in December 2017-December 2015 were selected as malignant group. In addition, 120 cases of benign ovarian tumors in the same period were selected as the benign group, and 92 healthy women who came to the hospital for health examination were selected as the control group. Serum HE4, CA125 levels and positive rates were detected by microparticle enzyme immunochemiluminescence assay, and ROMA index values were combined to assess the risk of ovarian cancer.Results:Malignant group serum CA125, HE4 level and ROMA index were significantly higher than those in the benign group and the control group, the level of CA125 in positive group was higher than control group, but the difference in level of HE4 and ROMA index between benign group and control group was not statistically significant. The positive rates of serum CA125, HE4 and ROMA index in malignant group were 76.4%, 92.7%, 96.4%, which were significantly higher than those in benign group (28.3%, 18.3%, 15%). The negative predictive value, positive predictive value, specificity and sensitivity of CA125 were all lower than those of HE4. The negative predictive value, positive predictive value, specificity and sensitivity of the combined ROMA index were higher than those of single diagnosis.Conclusions: Serum CA125, HE4 and ROMA index in elderly patients with ovarian cancer are significantly higher than those in elderly patients with benign ovarian tumors and healthy women. The combined diagnosis is the highest, with Gao Min's high sensitivity and specificity, which can be popularized in clinical practice.
文摘目的:研究卵巢恶性肿瘤患者发生静脉血栓栓塞症(venous thromboembolism,VTE)的危险因素。方法:回顾性分析2015年1月1日至2018年6月30日中山大学孙逸仙纪念医院妇科肿瘤专科收治的345例卵巢恶性肿瘤患者资料,其中31例发生VTE,314例未发生VTE。比较卵巢恶性肿瘤患者的年龄、身高、体质量、病理分期、病理类型、肿瘤标志物水平等,以研究卵巢恶性肿瘤患者发生静脉血栓的危险因素。结果:卵巢恶性肿瘤合并VTE组与无VTE组的年龄和手术病理分期差异有统计学意义(P<0.05);体质指数(body mass index,BMI)、病理类型的差异无统计学意义(P>0.05)。2组血肿瘤标志物(AFP、CEA、CA125、CA199、CA724、HE4)水平差异均无统计学意义(P>0.05)。Logistic分析提示手术病理分期是卵巢恶性肿瘤合并VTE的独立危险因素。结论:年龄和分期是卵巢恶性肿瘤合并VTE的危险因素,对年龄大以及肿瘤晚期的患者应重点预防和监测血栓的发生。
