Alcázar J L, Errasti T, Zornoza A, Mínguez J A, Galán M J
Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain.
Int J Gynaecol Obstet. 1999 Sep;66(3):255-61. doi: 10.1016/s0020-7292(99)00104-6.
To compare diagnostic performance of color Doppler ultrasound and CA-125 in suspicious adnexal masses on B-mode sonography.
Data on 94 patients (mean age: 47.4 years, range: 17-79 years. Fifty-two (55.3%) premenopausal and 42 (44.7%) postmenopausal women) managed in our institution because of a suspicious adnexal mass were reviewed. All patients were evaluated by transvaginal color Doppler ultrasonography (CD) and serum CA-125 level determination prior to surgery. Definitive histopathological diagnosis was obtained in each case. Sonographic morphology evaluation was suspicious in all cases. CD was considered as suspicious when flow was detected and the lowest RI found was < or = 0.45. CA-125 cut-off was > or = 35 UI/ml. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each method and compared. ROC analysis was performed for RI and CA-125. Areas under curve (AUC) were calculated and compared.
Fifty-six (59.6%) tumors were found to be malignant and 38 (40.4%) benign. Sensitivity, specificity, PPV and NPV for CD were 87.5% (95% CIs: 75.3-94.4), 84.2% (95% CIs: 68.7-94), 89.1% (95% CIs: 77.7-95.9) and 82.1% (95% CIs: 66.5-92.5), respectively. Sensitivity, specificity, PPV and NPV for CA-125 were 83.9% (95% CIs: 71.7-92.4), 68.4% (95% CIs: 51.3-82.5), 79.7% (95% CIs: 66.2-89) and 74.3% (95% CIs: 56.7-87.5), respectively. Sensitivity, PPV and NPV were not statistically different. CD had higher specificity (P = 0.01). AUC curve for Doppler (0.75) was significantly higher than for CA-125 (0.61) (P = 0.0002).
Our results indicate that color Doppler ultrasound has a better diagnostic performance as compared with CA-125, being significantly more specific.
比较彩色多普勒超声与CA - 125对B超检查发现的可疑附件包块的诊断性能。
回顾性分析我院收治的94例因可疑附件包块就诊患者的数据（平均年龄47.4岁，范围17 - 79岁。52例（55.3%）为绝经前女性，42例（44.7%）为绝经后女性）。所有患者在手术前均接受经阴道彩色多普勒超声（CD）检查及血清CA - 125水平测定。每例患者均获得明确的组织病理学诊断。所有病例超声形态学评估均为可疑。当检测到血流且最低阻力指数（RI）≤0.45时，CD被视为可疑。CA - 125临界值≥35 UI/ml。计算每种方法的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）并进行比较。对RI和CA - 125进行ROC分析。计算并比较曲线下面积（AUC）。
发现56例（59.6%）肿瘤为恶性，38例（40.4%）为良性。CD的敏感性、特异性、PPV和NPV分别为87.5%（95%置信区间：75.3 - 94.4）、84.2%（95%置信区间：68.7 - 94）、89.1%（95%置信区间：77.7 - 95.9）和82.1%（95%置信区间：66.5 - 92.5）。CA - 125的敏感性、特异性、PPV和NPV分别为83.9%（95%置信区间：71.7 - 92.4）、68.4%（95%置信区间：51.3 - 82.5）、79.7%（95%置信区间：66.2 - 89）和74.3%（95%置信区间：56.7 - 87.5）。敏感性、PPV和NPV差异无统计学意义。CD具有更高的特异性（P = 0.01）。多普勒的AUC曲线（0.75）显著高于CA - 125的AUC曲线（0.61）（P = 0.0002）。
我们的结果表明，与CA - 125相比，彩色多普勒超声具有更好的诊断性能，特异性显著更高。
