| ObjectivesThe value of International ovarian of tumor analysis Simple rules(IOTA SR),Gynecologic imaging reporting and data system(GI-RADS),the Risk of malignancy algorithm 1(RMI 1)which use the ultrasonographic morphological features as the main diagnostic method;The tumor marker as Carbohydrate antigen 125(CA125),Human epididymis protein 4(HE 4);Risk of ovarian malignancy index(ROMA)in differential diagnosis of benign and malignant ovarian tumors is to be investigated.MethodsA total of 100 patients with pelvic neoplasm who found in the First Affiliated Hospital of Jinzhou Medical University from July 2019 to July 2020 were selected.A total of 83 patients were screened after underwent unilateral or bilateral adnexal surgery and were confirmed by postoperative pathological examination by inclusion criteria.Routine examination,gynecological ultrasound examination,serum CA125 and serum HE4 examination were performed before the operation.IOTA SR score and GI-RADS score were performed according to the ultrasound results,and Roma value and RMI 1 value were calculated.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of each method were calculated using the recommended cut-off values.Receiver operating characteristic(ROC)curves were established and the area under the curve(AUC)were calculated using the measurement data.Results1、The Pathological ResultsPostoperative pathological results showed that 47 cases of benign ovarian tumor and 36 cases of malignant ovarian tumor.2、Serum CA125,serum HE 4,Roma and RMI 1 were used to diagnose benign and malignant ovarian tumorsIn ovarian benign tumors,serum CA 125 M(P25,P75)was 21.22(12.30,45.77),serum HE4 premenopausal M(P25,P75)was 49.96(42.60,56.36),postmenopausal `X±SD was 114.27±47.23 mm,ROMA premenopausal M(P25,P75)was 7.35(5.24,10.27),postmenopausal M(P25,P75)was 87.73(26.00,93.70),the RMI 1 M(P25,P75)was 38.84(18.93,76.21).While in ovarian malignant tumors,CA 125 M(P25,P75)was 301.06(76.22,677.95),HE 4 premenopausal M(P25,P75)was 307.88(83.20,405.68),postmenopausal `X±SD was 483.47±321.42 mm,ROMA premenopausal M(P25,P75)was 20.85(15.90,47.49),postmenopausal M(P25,P75)was 94.51(60.00,96.93),RMI 1 M(P25,P75)was 1078.76(302.38,3105.00).Compared with benign ovarian tumors,serum CA 125,He 4,ROMA and RMI 1 values in ovarian malignant tumors were significantly increased,which has statistical significance(P<0.05).3、Evaluation of diagnostic performance of IOTA SR,GI-RADS,RMI 1,Serum CA 125,Serum HE 4 and ROMAThe sensitivity of IOTA SR,GI-RADS,RMI 1,serum CA 125,serum He 4 and ROMA were 88.23%,83.33%,86.11%,91.67%,83.33%,88.89%,respectively.The specificity was 90.91%,87.23%,85.11%,63.83%,93.62%,89.36%,respectively.The positive prediction rates were 88.57%,83.33%,81.58%,66.00%,90.91%,86.49%,respectively.The negative prediction rates were 93.02%,87.23%,88.89%,90.91%,88.00%,91.30%,respectively.The Youden indices were 0.79,0.71,0.71,0.56,0.77 and 0.78,respectively.The area under ROC curve(AUC)of IOTA SR and GI-RADS were 0.899 and 0.853 respectively.The area under the curve(AUC)of serum CA 125,serum He 4,ROMA and RMI 1 ROC were 0.896,0.924,0.931 and 0.929,respectively.Conclusion(1)IOTA SR has high sensitivity and specificity in the differential diagnosis of benign and malignant ovarian tumors,and the diagnostic efficiency is better than methods of GI-RADS and serum CA 125.(2)The diagnostic efficiency of serum HE 4 is better than that of serum CA 125,which can be used as a routine diagnostic method for benign and malignant ovarian tumors in clinic.(3)ROMA and RMI 1 are conclusions drawn by combining a variety of traditional diagnostic methods,therefore,both of them have high diagnostic efficiency. |
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