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评估血清CA125和GI-RADS系统在附件包块评估中的诊断价值。

Assessment of the diagnostic value of using serum CA125 and GI-RADS system in the evaluation of adnexal masses.

作者信息

Zheng Heng, Tie Yan, Wang Xi, Yang Yang, Wei Xiawei, Zhao Xia

机构信息

Department of Gynecology and Obstetrics, Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu.

State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.

出版信息

Medicine (Baltimore). 2019 Feb;98(7):e14577. doi: 10.1097/MD.0000000000014577.

Abstract

Cancer antigen 125 (CA125) is a valuable tumor marker for ovarian cancer. Gynecology Imaging Reporting and Data System (GI-RADS) is proved to be effective at identifying the adnexal masses. We investigated whether the combination of these two methods can improve the diagnostic accuracy of ovarian cancer.We retrospectively analyzed preoperative data of 325 patients diagnosed with suspected adnexal mass, 196 patients with benign ovarian masses and 129 with malignant ovarian cancer (stage I: 34, II: 16, III: 61, IV: 18). CA125 was analyzed using the ARCHITECT system, GI-RADS was evaluated according to the International Ovarian Tumor Analysis consensus nomenclature and definitions. Sensitivities and specificities were also calculated for GI-RADS, CA125 and the combinations.The sensitivity, specificity and accuracy of CA125, GI-RADS were 75.97%, 79.59%, 78.15%, and 90.70%, 90.82%,90.77%, the combination data were 94.79%, 96.00%,95.53%. The AUC of combined diagnostic methods was the largest and significantly better compared with each method alone, P < .001). For stage I-II malignancy, GI-RADS as a single method was superior to CA125.Combined use of serum CA 125 and GI-RADS system improved the identification of adnexal masses at high risk of malignancy and could be used for clinical decision-making.

摘要

癌抗原125(CA125)是一种用于卵巢癌的重要肿瘤标志物。妇科影像报告和数据系统(GI-RADS)已被证明在识别附件包块方面有效。我们研究了这两种方法联合使用是否能提高卵巢癌的诊断准确性。我们回顾性分析了325例诊断为疑似附件包块患者的术前数据,其中196例为卵巢良性包块患者,129例为卵巢恶性癌患者(I期:34例,II期:16例,III期:61例,IV期:18例)。使用ARCHITECT系统分析CA125,根据国际卵巢肿瘤分析共识命名法和定义评估GI-RADS。还计算了GI-RADS、CA125及其联合使用的敏感性和特异性。CA125、GI-RADS的敏感性、特异性和准确性分别为75.97%、79.59%、78.15%,以及90.70%、90.82%、90.77%,联合使用的数据为94.79%、96.00%、95.53%。联合诊断方法的曲线下面积最大,与单独的每种方法相比有显著改善(P<0.001)。对于I-II期恶性肿瘤,GI-RADS作为单一方法优于CA125。血清CA 125和GI-RADS系统联合使用可提高对恶性风险高的附件包块的识别能力,可用于临床决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8662/6408110/487706878bdb/medi-98-e14577-g011.jpg

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