Frequency of Benign and Malignant Tumors in Localized Vitiligo in Comparison to Generalized and Universal Vitiligo

Background: Autoimmune diseases like pemphigus and systemic lupus erythematosus are protective against skin malignancies like basal cell carcinoma and squamous cell carcinoma. Objective: As vitiligo is an autoimmune diseases, the aim of the present work is to record the frequency of all benign and malignant skin tumors among patients with different severity of vitiligo and to be compared with the skin tumors in healthy control. Patients and Methods: This is a case series, descriptive study done in the Department of Dermatology—Baghdad Teaching Hospital, Baghdad, Iraq, during the period from May 2014-May 2015. History was taken from each patient with vitiligo regarding age, gender, duration, personal and family history of vitiligo and other autoimmune diseases such as diabetes mellitus, thyroid dysfunction, and alopecia areata. Patients were assessed for past and present history of photodermatosis and any skin cancers. Healthy control was considered. Results: Three hundred and fifty patients with vitiligo were included in this study: 50 patients with universal vitiligo, 100 patients with generalized vitiligo, and 200 patients with localized vitiligo as well as 500 subjects as a healthy control. The ages of all studied subjects ranged between 31 and 77 years. Twenty four(48%) patients with universal vitiligo were males and 26 (52%) were females;49(49%) patients with generalized vitiligo were males and 51(51%) were females;101(50.5%) patients with localized vitiligo were males and 99(49.5%) were females and 235(47%) of control were males and 265(53%) were females. All skin tumors were seen to be high in healthy subjects and lower or absent in patients with vitiligo. Also patients with mild vitiligo had a higher frequency of skin tumors including benign and malignant than patients with severe vitiligo especially in patients with universal vitiligo. In addition, no photosensitivity or actinic reticuloid was detected in patients with vitiligo. Conclusions: Vitiligo especially generalized and universal type as an autoimmune disease had a protective action against photodamage, photosensitivity and skin tumors whether benign or malignant.

Histochemical Patterns of Collagenic Fibers in the Benign and Malignant Breast Lesions

Cancer is one of the leading causes of death worldwide and breast cancer is the most commonly diagnosed cancer among women. An increased incidence of different types of breast cancer has been reported. This study was designed to evaluate the different types of breast cancer and its possible risk of neoplasmic transformation to an advanced malignant stage from a benign tumor. The histochemical patterns of collagen fibers in the benign and malignant breast lesions were evaluated. From the 50 tissue samples, 25 were malignant breast lesions and 25 were benign breast tumor. Hematoxylin and Eosin (HE), Van Gieson staining were performed to detect a benign and malignant tumor as well as collagen fibers. We found that significant cases after age of 35 were associated with ductal carcinoma while most of the cases within the age of 25 years were associated with fibrocystic changes. The intensity of collagen fiber was higher to Ductal Carcinoma while negative and less intense for Fibroblastic changes. Furthermore, a consistent association of other lesions, such as Lobular Carcinoma, Fibroadenoma, Papilloma and Fat necrosis and noticeable staining for collagen was observed for the different lesion. Our study suggested that women with age of 25 with benign lesion of fibrocystic change and ductal carcinoma are highly susceptible to develop advanced malignant tumor with age. Therefore, quantitative measurement of collagen fiber and regular follow-up are recommended to avoid the possible risk of developing advanced malignant lesions.

FTIR assessment of the secondary structure of proteins in human breast benign and malignant tissues

The compositions of the secondary structures of protein in the human breast normal, hyperplasia, fibroadenoma and invasive ductal carcinoma tissues have been estimated from the Fourier self deconvolved spectra, the second derivative spectra and the curve-fitting analysis of the amide I bands in their spectra. Some parameters of the secondary structures of proteins in these 4 types of tissues are significantly different and located in separate ranges.

Synchronous multiple primary malignant neoplasms in breast,kidney,and bilateral thyroid:A case report

BACKGROUND Multiple primary malignant neoplasms(MPMNs)are rare,while synchronous MPMNs(SMPMNs)are even less common.Owing to the progression of medical technology and the extension of life expectancy,its incidence is gradually increasing.CASE SUMMARY Although reports of breast and thyroid dual cancers are common,cases of an additional diagnosis of kidney primary cancer within the same individual are rare.CONCLUSION We present a case of simultaneous MPMN of three endocrine organs,reviewing the relevant literature to enhance our understanding of SMPMNs while emphasizing the increasingly important need for accurate diagnosis and multidisciplinary management whenever this challenging situation arises.

The choice of the immunosuppressant for the patients of the malignant tumors after kidney transplantation

Objective: To evaluate the efficacy and safety of the immunosuppressant treatment among 10 post-renal transplantation recipients with malignant tumors. Methods: Conversion to sirolimus (SRL) treatment was performed for 10 cases which had found malignant tumors after kidney transplantation. During the follow-up period, the recurrence and diffusion of the tumor, the renal function and rejection were monitored. Results: All these cases despite the death had been followed up for at least 1 year. 9 cases had no recurrence and diffusion. 1 case died due to the tumor diffusion 7 months after the drug conversion. 1 case suffered once acute rejection 2 months after the drug conversion. This acute rejection had been inhibited by flushing dose MP. Conclusion: As a new immunosuppressant, SRL not only can prevent the generation of AR, but inhibit proliferation and development of malignant tumors in kidney transplantation recipients as well.

Differentiation of malignant and benign lesions of the osseous spinal axis with three dimensional computed tomography image appearences: dirty interface sign

Purpose: We aimed to make a fast and accurate distinction of malignant and benign lesions in cases with predominantly solitary or multifocal involvement using latest technology software and hardware systems in computed tomography. Materials and Methods: 53 cases were included in the study. Primary (n = 42, 31 benign, 11 malignant) or metastatic (n = 11) tumors were detected at various locations in the bone structure of the cervical to coccygeal vertebrae in all cases. 3D CT images taken using the same system and biopsy or post-operative histopathology findings were available for all cases. Thin section images taken retrospectively from the archives were converted to 3D images using the same program and parameters, which were then recorded in the same window settings by two radiologists. Only 3D images were then analyzed to investigate the presence or absence of the dirty interface sign. Results: Dirty interface sign was present in 17 malignant lesions and absent in the remaining 5 lesions. As for benign lesions, the sign was present in only two lesions and the remaining 29 were negative for the sign. There was a high level of consistency between the two radiologists. In conclusion, malignant and benign lesions affecting the bone spinal axis were distinguished based on the presence or absence of the dirty interface sign with 77.3% sensitivity, 93.5% specificity and 86.8% accuracy. Conclusion: When evaluated with standard bone window views, 3D views can be used successfully for the distinction of malignant and benign bone tumors. At least, 3D views generated using low dose regimes in highly developed systems can be used with similar purpose to that of diffusion weighted MRI sequences that give roughly outlined but fast and accurate information about the lesion.

Alteration of Sex and Non-Sex Hormones and Distribution Features of Blood ABO System Groups among the Women with Uterine Body Tumors

Objectives: The aim of the investigation was to study the hormonal status (sex hormones: estradiol (E2), progesterone (P), testosterone (T);non-sex gonadotropic hormones-luteinizing hormone (LH) and follicle-stimulating hormone (FSH)) of women with benign and malignant tumors of uterine body in the reproductive, menopause and postmenopause periods. Also the distribution features of the blood ABO system phenotype groups and their link to the development of uterine body tumors have been studied. Methods: The determination of hormones was made by the enzyme analysis method (ELAIZA), provided by the proper ELAIZA kits. For the study of blood ABO system antigens, internationally recognized immunoserology methods were used. Results: Investigations revealed the increased level of E2 and T on the background of the reduced P in the blood of the women with uterine tumors in the reproductive, menopause and post-menopause period. As for gonadotropic hormones, the decreased levels of LH and FSH have also been detected. From the ABO system phenotype groups A(II) group had the highest frequency between the women with malignant uterine tumor in the reproductive age. O (I) phenotype group was the most frequent in case of menopause and post-menopause women with uterine malignant tumors. Conclusions: Hormonal imbalance creates good conditions for the proliferation of uterine tissues and hence causes the development of benign and malignant uterine tumors. The imbalance of the sex steroid and gonadotropic hormones in the blood of post-menopause women indicates on the genotoxic mechanism of cancer development on the background of age-related changes. A(II) group had the highest frequency between the reproductive age women with uterine malignant tumor, while O (I) group was the most frequent in case of menopause and post-menopause patients.

Classification of submucosal tumors in the gastrointestinal tract

This review is part two of three, which will present an update on the classification of gastrointestinal submucosal tumors. Part one treats of the diagnosis and part three of the therapeutic methods regarding gastrointestinal submucosal tumors. In the past there has been some confusion as to the classification of gastrointestinal submucosal tumors. Changes in classifications have emerged due to recent advances in mainly immunohistochemistry and electron microscopy. The aim of this paper is to update the reader on the current classification. Literature searches were performed to find information related to classification of gastrointestinal submucosal tumors. Based on these searches the twelve most frequent submucosal tumor types were chosen for description of their classification. The factors that indicate whether tumors are benign or malignant are mainly size and number of mitotic counts. Gastrointestinal stromal tumors are defined mainly by their CD117 positivity. In the future, there should be no more confusion between gastrointestinal stromal tumors and other types of submucosal tumors.

A retrospective study of 2228 cases with eyelid tumors

AIM： To describe the histopathologic and clinical features of eyelid tumor cases from Tianjin Eye Hospital during 2002 to 2015. METHODS： In this retrospective study, a total of 2228 cases of eyelid tumors with pathologic diagnoses were enrolled. The eyelid tumors were classified into three groups according to tumor origin： epidermal, adnexal and miscellaneous, including melanocytic, neural and vascular lesions. Inflammatory tumor-like lesions were excluded. The clinical characteristics of the eyelid tumors were analyzed, including age, gender and lesion location. RESULTS： Most eyelid tumors were epidermal in origin（1080, 48.5%）, followed by miscellaneous（885, 39.7%） and adnexal tumors（263, 11.8%）. Among all the tumors, 292（13.1%） were malignant lesions, 1910（85.7%） benign and 26（1.1%） premalignant lesions. Most malignant tumors originated from epidermal cells（60.0%）, followed by adnexal cells（34.6%）. The most common malignant tumors were basal cell carcinomas（56.5%） followed by sebaceous carcinoma（34.6%）, squamous cell carcinomas（3.8%） and lymphoma/plasmocytoma（1.7%）. The benign and premalignant eyelid lesions mostly originated from epidermal cells（46.4%） followed by miscellaneous cell sources（45.2%）, including melanocytic nevus（33.8%）, seborrheic keratosis（13.7%）, squamous cell papilloma（13.0%） and epidermal cysts（11.5%）. CONCLUSION： Eyelid tumors are mostly epithelial in origin. Benign tumors are significantly more common than malignant tumors with an obvious female predominance, and the most frequent malignant tumor are basal cell carcinoma, sebaceous carcinoma and squamous cell carcinomas. The tumor clinical features varied among the different subtypes.

Imaging appearance of bone tumors of the maxillofacial region

This paper reviews the imaging appearance of benign and malignant bone tumors of the maxillofacial region.A benign bone tumor commonly appears as a well circumscribed lesion.The matrix of the tumor may be calcified or sclerotic.Malignancies often display aggressive characteristics such as cortical breakthrough, bone destruction,a permeative pattern and associated soft-tissue masses.Computed tomography scan is an excellent imaging modality for accurate localization of the lesion,characterization of the tumor matrix and detection of associated osseous changes such as bone remodeling,destruction or periosteal reaction.Magnetic resonance imaging is of limited value in the evaluation of maxillofacial bone tumors.

Central pancreatectomy:a new technique for resection of selected pancreatic tumors

BACKGROUND:Pancreatic tumors located in the neck region usually require pancreaticoduodenectomy or splenopancreatectomy.For small benign tumors enucleation is not usually feasible due to their size and localization;then pancreatectomy is often needed.Central pancreatectomy consists of a limited resection of the midportion of the pancreas and can be offered in benign and low-grade malignant tumors of the neck of the pancreas.The study aimed to evaluate whether central pancreatectomy has a place in pancreatic surgery. METHODS:In this study,which covered a period of 14 months,we performed central pancreatectomy in four selected patients.Preoperative evaluation and operative frozen section biopsy in indicated cases allowed proper selection for the procedure.Operative details,complications and follow-up were recorded. RESULTS:Four patients,two with serous cystadenoma,and one with an islet cell tumor,and one with a hydatid cyst, were identified for the procedure.The mean tumor size was 3 cm,the mean operative time was 217.5 minutes,and the mean blood loss was 382.5 ml.There was no morbidity or mortality in this series.No endocrine or exocrine deficiency was observed in any patient during a mean follow-up of 22.7 months. CONCLUSIONS:Central pancreatectomy is a procedure that offers excellent results in benign and low-grade malignant tumors.It preserves functional elements(endocrine and exocrine)of the pancreas and also eliminates the infective and hematological effects of splenectomy.Thus,central pancreatectomy should be included in the armamentarium of pancreatic surgery,and in order to obtain good results,proper indications and adequate experience are recommended.

Pancreas-preserving duodenectomy for treatment of a duodenal papillary tumor:A case report

BACKGROUND Duodenal papillary tumor is a rare tumor of the digestive tract,accounting for about 0.2%of gastrointestinal tumors and 7%of periampullary tumors.The clinical manifestations of biliary obstruction are most common.Some benign tumors or small malignant tumors are often not easily found because they have no obvious symptoms in the early stage.Surgical resection is the only treatment for duodenal papillary tumors.At present,the methods of operation for duodenal papillary tumors include pancreatoduodenectomy,duodenectomy,ampullectomy,and endoscopic resection.CASE SUMMARY A 47-year-old man was admitted to because of a duodenal mass that had been discovered 2 mo previously.Electronic gastroscopy at another hospital revealed a duodenal papillary mass that had been considered to be a high-grade intraepithelial neoplasia.Therefore,we conducted a multidisciplinary group discussion and decided to perform a pancreas-preserving duodenectomy and a R0 resection was successfully performed.After surgery,the patient underwent a follow-up period of 5 yr.No recurrence or metastasis occurred.CONCLUSION According to our experience with a duodenal papillary tumor,compared with pancreaticoduodenectomy,the use of pancreas-preserving duodenectomy can preserve pancreatic function,maintain gastrointestinal structure and function,reduce tissue damage and complications,and render the postoperative recovery faster.Pancreas-preserving duodenectomy for treatment of a duodenal papillary tumor is feasible under strict control of surgical indications.

A Gaussian Multivariate Hidden Markov Model for Breast Tumor Diagnosis

The stage of a tumor is sometimes hard to predict, especially early in its development. The size and complexity of its observations are the major problems that lead to false diagnoses. Even experienced doctors can make a mistake in causing terrible consequences for the patient. We propose a mathematical tool for the diagnosis of breast cancer. The aim is to help specialists in making a decision on the likelihood of a patient’s condition knowing the series of observations available. This may increase the patient’s chances of recovery. With a multivariate observational hidden Markov model, we describe the evolution of the disease by taking the geometric properties of the tumor as observable variables. The latent variable corresponds to the type of tumor: malignant or benign. The analysis of the covariance matrix makes it possible to delineate the zones of occurrence for each group belonging to a type of tumors. It is therefore possible to summarize the properties that characterize each of the tumor categories using the parameters of the model. These parameters highlight the differences between the types of tumors.

基于瘤体及瘤周多参数MRI对乳腺病变良恶性诊断列线图预测模型的构建与评价

目的:建立基于瘤体及瘤周多参数MRI的乳腺病变良恶性鉴别诊断的列线图模型,并验证其预测效能。方法:纳入经病理学检查明确乳腺病变性质的100例患者作为研究对象,所有患者均行核磁共振(MRI)检查和病理检查,根据病理检查结果分为乳腺良性病变组(n=62)和乳腺恶性病变组(n=38)。收集患者临床资料、瘤体各参数、瘤周各参数以及乳腺病变良恶性情况。多因素Logistic回归分析筛选乳腺恶性病变的危险因素并构建列线图预测模型,采用受试者工作特征(ROC)曲线和Hosmer-Lemeshow拟合优度检验验证模型的预测效能及拟合优度;内部验证采用Bootstrap。结果:乳腺恶性病变组病灶直径、平均扩散峰度(MK)、MDp/t、瘤周与瘤体MKp/n高于乳腺良性病变组(均P<0.05);乳腺恶性病变组表观扩散系数(ADC)值、平均扩散率(MD)、非对称磁化转移率(MTRasym)、MKp/t、MDp/n低于乳腺良性病变组(均P<0.05)。多因素分析结果显示,病灶直径、MK、MDp/t、MKp/n升高,ADC值、MD、MTRasym、MKp/t、MDp/n降低是乳腺恶性病变的独立影响因素(均P<0.05)。基于上述独立影响因素构建乳腺恶性病变的列线图预测模型,曲线下面积(AUC)为0.827。Hosmer-Lemeshow拟合优度检验显示P值为0.004。采用Bootstrap法,生成的校准曲线拟合良好。结论:瘤体及瘤周多参数MRI对乳腺病变良恶性鉴别诊断具有重要预测价值,基于乳腺恶性病变的独立影响因素构建的列线图预测效果良好,能直观预测乳腺发生恶性病变的概率。

Nephroblastoma in Adults about a Clinical Case

Nephroblastoma is the most common malignant renal tumor in children and is related to an abnormal proliferation of cells resembling those of the embryonic kidney (metanephroma), hence the terminology;embryonal tumor. These are tumors that remain and remain unstudied in Mali because they are common in adults in our context. Its annual incidence is estimated at approximately 1/10,000 births. Nephroblastoma is a rare or even exceptional tumor in adults. The clinical manifestation was a large swelling of the right hypochondrium;abdominal pain for a year;unquantified fever, hypertension, initial hematuria associated with burning during urination and anemia. The main clinical manifestation remained fever and abdominal pain. This renal tumor posed a diagnostic problem which was previously labeled as a mesenteric tumor in our general surgery department. The diagnosis was made by imaging: CT and magnetic resonance imaging. The treatment is multidisciplinary and combines chemotherapy, surgery with or without radiotherapy. The prognosis is poor due to late diagnosis and less effectiveness of chemotherapy compared to the child. Survival did not exceed a year and a half because the renal tumor in our patient was surgically overcome. We report a case of nephroblastoma in an 86-year-old patient with unfavorable histology (hematogenous metastases), operated on in the general surgery department and whose postoperative course was simple and who was referred to oncology for treatment.

增强CT中病灶皮质衰减比在小肾肿瘤良恶性鉴别诊断中的应用研究

目的提出全新参数—病灶皮质衰减比;并讨论其在增强CT中小肾肿瘤(病灶直径<4cm)的良恶性鉴别诊断中的临床应用价值。方法回顾性收集我院及四川省人民医院肾脏肿瘤患者的术前多期增强CT 70例。由两名有临床诊断经验的放射科医生采用双盲法分别记录肾脏肿瘤增强CT中的典型影像征象(边缘形态、强化类型、血管侵犯、肾周脂肪侵犯等)。并于肿瘤及邻近肾皮质区域分别选取感兴趣区域,计算病灶皮质衰减比。观察以上指标在小肾脏肿瘤不同良恶性亚型(肾嗜酸细胞腺瘤、平滑肌瘤、透明状细胞癌、乳头状细胞癌)间的表现。结果不同于恶性肾脏肿瘤,本研究中全部的良性肾脏肿瘤均呈现边缘清晰、无血管或肾周脂肪侵犯。肾嗜酸细胞腺瘤的病灶皮质衰减比与透明状细胞癌(P<0.05)和乳头状细胞癌(P<0.05)均有统计学差异。结论肾脏增强CT中病灶皮质衰减比可将有代表性的肾细胞癌(肾透明状细胞癌)与良性肿瘤(肾嗜酸细胞腺瘤)显著分层。具有临床应用价值。

经阴道超声联合血清SLPI、SMRP检测对卵巢肿瘤良恶性的诊断价值

目的探究经阴道超声(TVUS)联合血清分泌性白细胞肽酶抑制因子(SLPI)、可溶性间皮素相关肽(SMRP)检测对卵巢肿瘤良恶性的诊断价值。方法选择2022年1月—2023年6月陕西中医药大学第二附属医院妇科诊治的卵巢肿瘤患者120例,根据病理诊断结果分为良性组(70例)和恶性组(50例);使用彩色多普勒超声诊断仪对患者进行灰度超声检查和彩色多普勒超声检查并记录各项参数,ELISA检测血清SLPI、SMRP水平;多因素Logistic回归分析方法分析卵巢肿瘤良恶性的影响因素;ROC曲线分析TVUS联合SLPI、SMRP对卵巢肿瘤良恶性的诊断价值。结果良性组中TVUS阴性59例(84.3%)、阳性11例(15.7%),恶性组中阳性33例(66.0%),阴性17例(34.0%)(χ^(2)=31.759,P<0.001);恶性组病灶最大直径、收缩期最高峰值血流速度(Vs)、舒张期最低峰值血流速度(Vd)高于良性组(t/P=6.074/<0.001,3.247/0.002,3.048/0.003);与良性组比较,恶性组血清SLPI、SMRP水平较高(t=7.515,7.818,P<0.001)。多因素Logistic回归分析结果表明,SLPI高、SMRP高、Vs高、Vd高为卵巢恶性肿瘤的独立危险因素[OR(95%CI)=1.625(1.066~2.477),1.834(1.053~3.194),1.375(1.033~1.831),1.624(1.059~2.490)];ROC曲线分析结果表明,TVUS、血清SLPI、SMRP及三者联合诊断卵巢肿瘤良恶性的AUC分别为0.751、0.820、0.813、0.948,三者联合诊断的AUC优于各自单独诊断(Z=5.468、3.441、3.517,P均<0.001)。结论SLPI、SMRP在卵巢恶性肿瘤患者血清中表达上升,是恶性肿瘤发生的影响因素,TVUS联合血清SLPI、SMRP诊断卵巢肿瘤良恶性具有较高的价值,可用于临床实践。

出生日期五运六气对后天罹患乳房肿瘤良恶性倾向的趋势性分析

【目的】探讨女性乳房良恶性肿瘤患者出生日期的五运六气特点以及异同性,并围绕罹患乳房肿瘤的良恶性倾向展开趋势性分析。【方法】从广州中医药大学第一附属医院的电子病例系统中采集723例乳房恶性肿瘤(乳腺癌)患者和1595例乳房良性肿瘤患者的出生日期信息,运用SPSS 25.0统计学软件对2组患者的运气学信息进行统计分析。【结果】(1)岁运方面,木运太过、火运太过、土运不及之年出生的患者倾向性于罹患乳腺癌,而金运不及、木运不及、水运太过之年出生的患者倾向于患乳房良性肿瘤。(2)主气方面,出生于少阴君火的患者更倾向于罹患乳腺癌,而出生于厥阴风木、太阴湿土的患者更倾向于患乳房良性肿瘤。(3)客气方面,出生于厥阴风木、阳明燥金的患者更倾向于罹患乳腺癌,而出生于少阳相火、太阳寒水的患者更倾向于患乳房良性肿瘤。(4)出生季节方面,出生于春季的患者更倾向于罹患乳腺癌。(5)运气相合方面,出生于小逆/不和/天刑的患者患乳腺癌的倾向性更大,而出生于岁会/同岁会的患者更倾向于患乳房良性肿瘤。(6)司天-在泉方面,出生之年的司天-在泉组合情况对乳腺癌和乳房良性肿瘤的影响并无明显的统计学差异。【结论】(1)乳房良恶性肿瘤之间的出生日期的运气信息有一定的差异性和倾向性。(2)从运气学角度分析,乳腺癌患者出生日期的相关运气气候以风、热为特点,病变部位主要涉及肝、脾、心、肾,且相较于乳房良性肿瘤患者,其体质禀赋更偏向于实性、热性。

超声卵巢-附件影像报告和数据系统鉴别诊断卵巢肿瘤良恶性的Meta分析

目的 系统评价超声卵巢-附件影像报告和数据系统(O-RADS)鉴别诊断卵巢肿瘤良恶性的临床价值。方法 计算机检索Cochrane Library、Embase、Web of Science及Pubmed数据库,搜索O-RADS鉴别诊断卵巢肿瘤良恶性的相关文献,检索时间均为建库至2023年9月19日。由3名研究者独立筛查文献、提取资料,然后利用QUADAS-2量表对纳入文献质量进行评价;应用Stata 17.0、Meta-Disc 1.4及RevMan 5.3软件进行Meta分析。结果 最终纳入18篇文献,包括10 944例患者,共计11 189个肿瘤。Meta分析结果显示,O-RADS鉴别诊断卵巢肿瘤良恶性的合并灵敏度、特异度、阳性似然比、阴性似然比、诊断得分及诊断比值比分别为0.95[95%可信区间(CI):0.93~0.98]、0.79(95%CI:0.73~0.84)、4.59(95%CI:3.57~5.89)、0.05(95%CI:0.03~0.09)、4.52(95%CI:3.91~5.13)及91.79(95%CI:49.79~169.27);综合受试者工作特征曲线分析显示,O-RADS鉴别诊断卵巢肿瘤良恶性的曲线下面积为0.94(95%CI:0.92~0.96)。结论 O-RADS在鉴别诊断卵巢肿瘤良恶性方面具有较好的临床应用价值。

基于简化流程图的O-RADS联合ADNEX模型评估中老年女性附件肿瘤良恶性的临床应用

目的探讨基于简化流程图的O-RADS联合ADNEX模型评估中老年女性附件肿瘤良恶性的临床应用。方法选取2018年11月—2022年11月在桂林医学院附属医院行妇科超声检查发现附件肿瘤且行手术治疗的中老年患者95例。根据O-RADS及ADNEX模型对附件肿瘤进行分类,以病理组织学作为金标准,计算出O-RADS、ADNEX模型及两者联合的诊断效能,绘制受试者工作特征(ROC)曲线。结果95例患者中,病理结果恶性46例、良性49例。O-RADS 4、5类诊断附件恶性肿瘤的敏感性、特异性、阳性预测值、阴性预测值分别为93.48%(95%CI:0.811,0.983)、69.39%(95%CI:0.544,0.813)、74.14%、91.89%,ADNEX模型诊断附件肿瘤良恶性的敏感性、特异性、阳性预测值、阴性预测值分别为89.13%(95%CI:0.756,0.959)、79.59%(95%CI:0.652,0.893)、80.39%、88.63%,两者联合诊断附件肿瘤良恶性的敏感性、特异性、阳性预测值、阴性预测值分别为93.48%(95%CI:0.811,0.983)、83.67%(95%CI:0.698,0.922)、84.31%和93.18%。O-RADS、ADNEX模型及其联合诊断附件肿瘤良恶性的曲线下面积分别0.814、0.844、0.871。由2位超声医师运用O-RADS分类诊断的一致性好(κ=0.847,P=0.000),运用O-RADS简化流程图者较颜色编码计分表格者用时更短,分别为42 min 39 s和51 min 3 s。结论O-RADS联合ADNEX模型诊断中老年女性附件肿瘤良恶性的价值较单独使用O-RADS高,不同超声医师使用O-RADS有较高的一致性,且使用简化流程图者可更快速进行分类,值得推广。