经数学建模临床指标和超声参数评估绝经期子宫内膜病变。

Evaluation of menopausal endometrial lesions via mathematical modeling clinical indicators and ultrasonographic parameters.

出版信息

Technol Health Care. 2022;30(S1):535-544. doi: 10.3233/THC-228049.

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9028664/

Abstract

BACKGROUND

The diagnosis of benign and malignant menopausal endometrial lesions (MEL) is often misled by complicated clinical indicators and ultrasonographic parameters in actual clinical applications.

OBJECTIVE

To investigate the performance of clinical indicators and ultrasonographic parameters in the diagnosis of MEL.

METHODS

A cohort of 156 enrolled menopausal patients with MEL was divided into benign group (128 cases) and malignant group (28 cases). Two clinical indicators of patient age (PA), abnormal vaginal bleeding (AVB) and three transvaginal ultrasonography (TVS) parameters of endometrial thickness (ET), endometrial uneven echo (EUE) and endometrial blood flow signal (EBFS) were measured for the mathematical modelling. The performance of combined indicators and individual indicators were firstly compared, and then the optimized combined indicators was compared with corresponding individual indicators, respectively.

RESULTS

Our experiments verified that the mathematical modelling presented robust capabilities in the diagnosis of MEL with the sensitivity, specificity and AUC of 78.6%, 75.8% and 0.83 for combined indicators, and 75.0%, 81.3% and 0.85 for optimized combined indicators, respectively. The cut off thresholds of PA was 57.5 years, ET was 11.5 mm. Furthermore, the AVB presented the most important risk factor among the optimized indicators of PA, ET and AVB (P< 0.05).

CONCLUSIONS

The combined indicators presented better performance in differentiating benign and malignant MEL and the AVB demonstrated the most capability for clinical applications.

摘要

背景

在实际临床应用中，良性和恶性绝经后子宫内膜病变（MEL）的诊断常因复杂的临床指标和超声参数而产生误导。

目的

探讨临床指标和超声参数在 MEL 诊断中的表现。

方法

对 156 例绝经后 MEL 患者进行队列研究，分为良性组（128 例）和恶性组（28 例）。测量患者年龄（PA）、异常阴道出血（AVB）两个临床指标和子宫内膜厚度（ET）、子宫内膜不均匀回声（EUE）、子宫内膜血流信号（EBFS）三个经阴道超声（TVS）参数，进行数学建模。首先比较联合指标和单项指标的性能，然后比较优化后的联合指标与相应的单项指标。

结果

实验验证了数学建模在 MEL 诊断中具有强大的能力，联合指标的敏感性、特异性和 AUC 分别为 78.6%、75.8%和 0.83，优化后的联合指标分别为 75.0%、81.3%和 0.85。PA 的截止阈值为 57.5 岁，ET 为 11.5mm。此外，在 PA、ET 和 AVB 的优化指标中，AVB 是最重要的危险因素（P<0.05）。