细化超声评分法在术前评估卵巢肿瘤良恶性中的应用价值

Ultrasound in preoperative evaluation of benign and malignant ovarian tumors

关键词:  卵巢肿瘤  超声  肿瘤标志物  评分法

Key words:  ovarian neoplasms  ultrasound  tumor markers  scoring

摘要:

目的　探讨细化超声评分法在术前评估卵巢肿瘤良恶性中的应用价值。方法　取2017年9月至2018年3月经病理证实的卵巢肿瘤64个，术前行常规超声及弹性超声检查，基于IOTA准则将标准细化并人为进行赋分，计算各评分法诊断卵巢肿瘤良恶性的灵敏度、特异度、准确率及ROC曲线下面积。结果　术后病理证实良性肿瘤47个，恶性肿瘤17个，细化超声评分法中良性肿瘤平均分值为8.66±0.59（95%CI为7.84-9.84），恶性肿瘤平均分值为23.06±1.66（95%CI为19.53-26.59），以≥15.5分作为恶性肿瘤判断的标准，其灵敏度为88.20%，特异度为95.70%，准确率为83.99%，ROC曲线下面积为0.95；细化超声+弹性超声评分法中良性肿瘤平均分值为10.30±0.69（95%CI为8.91-11.69），恶性肿瘤平均分值为26.35±1.85（95%CI为22.44-30.27），以≥17.5分作为恶性肿瘤判断的标准，其灵敏度为88.20%，特异度为95.70%，准确率为83.99%，ROC曲线下面积为0.947。结论　细化超声评分法在术前评估卵巢肿瘤良恶性中具有较高诊断价值，弹性超声可辅助诊断，但并不能提高诊断效能。

Abstract:

Objective　To explore the value of refinement ultrasound scoring in the evaluation of benign and malignant ovarian tumors before operation. 　Methods　Sixty-four ovarian neoplasms confirmed by pathology from September 2017 to March 2018 were examined by routine ultrasound and elasticity ultrasound. The criteria were refined and artificially assigned based on IOTA criteria. Each score method was used to diagnose ovarian tumors. Diagnostic sensitivity, specificity, accuracy, and area under the ROC curve were analyzed. 　Results　Postoperative pathology revealed 47 benign tumors and 17 malignant tumors. The average score of benign tumors in the refined ultrasound scoring method was 8.66±0.59 (95% confidence interval was 7.84-9.84), and the average score of malignant tumors was 23.06±1.66 (95% confidence interval was 19.53-26.59). With a score of greater than 15.5 as a criterion for malignant tumors, the sensitivity was 88.20%, the specificity was 95.70%, the accuracy rate was 83.99%, the area under the ROC curve was 0.95. The mean score of benign tumors in the elastic ultrasound scoring method was 10.30±0.69 (95% confidence interval was 8.91-11.69), and the average score of malignant tumors was 26.35±1.85 (95% confidence interval was 22.44-30.27). With a score of greater than 17.5 points as a criterion for judging malignant tumors, the sensitivity was 88.20%, the specificity was 95.70%, the accuracy rate was 83.99%, and the area under the ROC curve was 0.947. 　Conclusion　The refined ultrasound scoring method has a high diagnostic value in preoperative evaluation of benign and malignant ovarian tumors. Elastic ultrasound can assist diagnosis, but it can not improve the diagnostic efficiency.