卵巢体积和卵泡数量在中国女性多囊卵巢综合征诊断中的应用
Ovarian volume and follicle number in the diagnosis of polycystic ovary syndrome in Chinese women.
作者信息
Chen Y, Li L, Chen X, Zhang Q, Wang W, Li Y, Yang D
机构信息
Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
出版信息
Ultrasound Obstet Gynecol. 2008 Oct;32(5):700-3. doi: 10.1002/uog.5393.
OBJECTIVE
To assess the value of ovarian volume and follicle number in the diagnosis of polycystic ovary syndrome (PCOS) in a Chinese population.
METHODS
This study included 432 women with PCOS selected using the National Institutes of Health criteria, who were compared with 153 age-matched women as controls. All participants were given a transvaginal or transrectal ultrasound scan during day 3-5 of the menstrual cycle (for regularly menstruating women) or randomly (for oligomenorrheic or amenorrheic women). The ovarian volume (calculated using the simplified formula: 0.5 x length x height x width) and follicle number were obtained and the best diagnostic cut-off values were evaluated using receiver-operating characteristics (ROC)-curve analysis.
RESULTS
The 10(th) and 90(th) centiles of ovarian volume in PCOS patients were 4.89 and 15.79 cm(3), respectively, and the median was 9.21 cm(3); the 10(th) and 90(th) centiles of follicle number were 8 and 19, respectively, and the median was 12. The 10(th) and 90(th) centiles of ovarian volume in controls were 2.43 and 7.75 cm(3), respectively, and the median was 4.46 cm(3); the 10(th) and 90(th) centiles of follicle number were 3 and 10, respectively, and the median was 6. The differences in ovarian volume and follicle number between patients and controls were statistically significant. The areas under the ROC curves for mean ovarian volume (MOV), maximum ovarian volume (MaxOV), mean follicle number (MFN) and maximum follicle number (MaxFN) to diagnose PCOS were 0.898, 0.882, 0.909 and 0.911, respectively. Setting the threshold for MOV at 6.4 cm(3) (sensitivity 81%, specificity 85.6%), the threshold for MaxOV at 7.9 cm(3) (sensitivity 78%, specificity 85.6%), the threshold for MFN at 10 (sensitivity 85.2%, specificity 88.8%) and the threshold for MaxFN at 12 (sensitivity 85.2%, specificity 92.6%) obtained the best compromise between sensitivity and specificity, based on the Youden index.
CONCLUSIONS
We conclude that ovarian volume and follicle number have satisfactory power for use in the diagnosis of PCOS. Cut-offs of 6.4 cm(3), 7.9 cm(3), 10 and 12, for MOV, MaxOV, MFN and MaxFN, respectively, obtained the best compromise between sensitivity and specificity for the diagnosis of PCOS in Chinese women.
目的
评估卵巢体积和卵泡数量在中国人群多囊卵巢综合征（PCOS）诊断中的价值。
方法
本研究纳入432例根据美国国立卫生研究院标准选取的PCOS女性患者，并与153例年龄匹配的女性作为对照。所有参与者在月经周期第3 - 5天（月经规律的女性）或随机（月经稀发或闭经的女性）接受经阴道或经直肠超声扫描。获取卵巢体积（使用简化公式计算：0.5×长×高×宽）和卵泡数量，并使用受试者工作特征（ROC）曲线分析评估最佳诊断截断值。
结果
PCOS患者卵巢体积的第10和第90百分位数分别为4.89和15.79 cm³，中位数为9.21 cm³；卵泡数量的第10和第90百分位数分别为8和19，中位数为12。对照组卵巢体积的第10和第90百分位数分别为2.43和7.75 cm³，中位数为4.46 cm³；卵泡数量的第10和第90百分位数分别为3和10，中位数为6。患者与对照组之间卵巢体积和卵泡数量的差异具有统计学意义。平均卵巢体积（MOV）、最大卵巢体积（MaxOV）、平均卵泡数量（MFN）和最大卵泡数量（MaxFN）诊断PCOS的ROC曲线下面积分别为0.898、0.882、0.909和0.911。根据约登指数，将MOV的阈值设定为6.4 cm³（敏感性81%，特异性85.6%），MaxOV的阈值设定为7.9 cm³（敏感性78%，特异性85.6%），MFN的阈值设定为10（敏感性85.2%，特异性88.8%），MaxFN的阈值设定为12（敏感性85.2%，特异性92.6%）时，在敏感性和特异性之间取得了最佳折衷。
结论
我们得出结论，卵巢体积和卵泡数量在PCOS诊断中具有令人满意的诊断效能。对于中国女性PCOS的诊断，MOV、MaxOV、MFN和MaxFN的截断值分别为6.4 cm³、7.9 cm³、10和12时，在敏感性和特异性之间取得了最佳折衷。
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