形态指数对卵巢异常的连续超声评估。

Serial ultrasonographic evaluation of ovarian abnormalities with a morphology index.

机构信息

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY, United States.

出版信息

Gynecol Oncol. 2014 Oct;135(1):8-12. doi: 10.1016/j.ygyno.2014.07.091. Epub 2014 Jul 25.

DOI:10.1016/j.ygyno.2014.07.091

PMID:25068975

Abstract

OBJECTIVE

Transvaginal ultrasonography with tumor morphology index (MI) has been used to predict the risk of ovarian malignancy. Our objective was to analyze changes in serial MI scores for malignant and non-malignant ovarian tumors in a large and asymptomatic population.

METHODS

Eligible subjects participated in the University of Kentucky Ovarian Cancer Screening Program and had abnormalities that included cysts, cysts with septations, complex cysts with solid areas, and solid masses. Analysis included: MI, change in MI (delta MI), delta MI per scan and per month, number and duration of scans.

RESULTS

From 1987 to 2012, 38,983 women received 218,445 scans. Of the 7104 eligible subjects, 6758 tumors were observed without surgery and 472 were surgically removed. Eighty-six percent (5811) of observed tumors were resolved. There were 74 malignant and 272 non-malignant tumors. Eighty-five percent of malignancies had MI ≥5 at decision for surgery. The risk of malignancy based on MI was: MI=5 (3%), MI=6 (3.7%), MI=7 (12.6%), MI=8 (26.7%), MI=9 (27.8%), MI=10 (33.3%). The mean delta MI per month decreased for tumors that resolved (delta MI -1.0, p<0.001) or persisted without surgery (delta MI -0.7, p<0.001). For abnormalities surgically removed, the mean delta MI per month increased significantly more for malignancies than for benign tumors (delta MI +1.6 vs. +0.3, p<0.001).

CONCLUSIONS

The mean MI for malignant ovarian tumors increases over time, while non-malignant tumors have a decreasing or stable MI. Serial MI analysis can improve the prediction of ovarian malignancy by reducing false-positive results, thereby decreasing the number of operations performed for benign abnormalities.

摘要

目的

经阴道超声肿瘤形态指数（MI）已用于预测卵巢恶性肿瘤的风险。我们的目的是分析在一个大型无症状人群中，良性和恶性卵巢肿瘤的连续 MI 评分的变化。

方法

符合条件的受试者参加了肯塔基大学卵巢癌筛查计划，并存在包括囊肿、分隔囊肿、实性区域的复杂囊肿和实性肿块等异常。分析包括：MI、MI 变化（ΔMI）、每次扫描和每月的 ΔMI、扫描次数和持续时间。

结果

1987 年至 2012 年，38983 名女性接受了 218445 次扫描。在 7104 名符合条件的受试者中，6758 个肿瘤未经手术观察，472 个肿瘤经手术切除。86%（5811）的观察性肿瘤得到解决。观察到的肿瘤中，有 74 个为恶性肿瘤，272 个为良性肿瘤。85%的恶性肿瘤在手术决策时的 MI≥5。基于 MI 的恶性肿瘤风险为：MI=5（3%），MI=6（3.7%），MI=7（12.6%），MI=8（26.7%），MI=9（27.8%），MI=10（33.3%）。解决的肿瘤的每月平均 ΔMI 减少（ΔMI-1.0，p<0.001）或未经手术持续存在的肿瘤（ΔMI-0.7，p<0.001）。对于手术切除的异常，恶性肿瘤的每月平均 ΔMI 增加明显高于良性肿瘤（ΔMI+1.6 比+0.3，p<0.001）。