Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, 200072, China.
Department of Radiology, Huadong Hospital of Fudan University, Shanghai, 200040, China.
Abdom Radiol (NY). 2020 Oct;45(10):3230-3238. doi: 10.1007/s00261-020-02467-w.
To investigate the value of CT and MR imaging features in differentiating borderline ovarian tumor (BOT) from type I ovarian epithelial cancer (OEC), which could be significant for suitable clinical treatment and assessment of the prognosis of the patient.
Thirty-three patients with BOTs and 35 patients with type I OECs proven by pathology were retrospectively evaluated. The clinico-pathological information (age, premenopausal status, CA-125, and Ki-67) and imaging characteristics were compared between two groups of ovarian tumors. The diagnostic performance of the imaging features was evaluated using receiver operating characteristic analysis. The best predictor variables for type I EOCs were recognized via multivariate analyses.
BOTs are more likely to involve younger patients and frequently show lower CA-125 values and lower proliferation indices (Ki-67 < 15%) than type I OECs. Compared with type I OECs, BOTs were more often purely cystic (15/33, 45.45% vs. 1/35, 2.86%; p < 0.001) and displayed less frequent mural nodules (16/33, 48.48% vs. 28/35, 80.00%; p = 0.007), less frequently unclear margin (3/33, 9.09% vs. 11/35, 31.43%; p = 0.023), smaller solid portion (0.56 ± 2.66 vs. 4.51 ± 3.88; p < 0.001), and thinner walls (0.3 ± 0.17 vs. 0.55 ± 0.24; p < 0.001). The maximum wall thickness presented the largest area under the curve (AUC, 0.848). Multivariate analysis revealed that the solid portion size (OR 10.822, p = 0.002) and maximum wall thickness (OR 9.130, p = 0.001) were independent indicators for the differential diagnosis between the two groups of lesions.
The solid portion size and maximum wall thickness significantly influenced the classification of the two groups of ovarian tumors.
探讨 CT 和 MRI 成像特征在鉴别交界性卵巢肿瘤（BOT）与Ⅰ型卵巢上皮性癌（OEC）中的价值，这对于患者的临床治疗和预后评估具有重要意义。
回顾性分析 33 例经病理证实的 BOT 患者和 35 例Ⅰ型 OEC 患者的临床病理资料（年龄、绝经前状态、CA-125 和 Ki-67）及影像学特征。采用受试者工作特征（ROC）曲线分析评估两组卵巢肿瘤的影像学特征的诊断效能。通过多因素分析识别出对Ⅰ型 EOC 有预测价值的最佳变量。
BOT 患者较Ⅰ型 OEC 患者更年轻，且 CA-125 值更低（P < 0.001），增殖指数（Ki-67 < 15%）更低（P < 0.001）。与Ⅰ型 OEC 相比，BOT 更常表现为单纯性囊性（15/33，45.45%比 1/35，2.86%；P < 0.001），且较少出现壁结节（16/33，48.48%比 28/35，80.00%；P = 0.007），边界更清晰（3/33，9.09%比 11/35，31.43%；P = 0.023），实性部分更小（0.56 ± 2.66 比 4.51 ± 3.88；P < 0.001），且壁更薄（0.3 ± 0.17 比 0.55 ± 0.24；P < 0.001）。最大壁厚的曲线下面积（AUC）最大（0.848）。多因素分析显示，实性部分大小（OR 10.822，P = 0.002）和最大壁厚（OR 9.130，P = 0.001）是两组病变鉴别诊断的独立指标。
实性部分大小和最大壁厚显著影响两组卵巢肿瘤的分类。
