IOTA SR 和 O-RADS 联合 CA125、HE4 和恶性风险算法对附件肿块良恶性的诊断性能。

Diagnostic performance of IOTA SR and O-RADS combined with CA125, HE4, and risk of malignancy algorithm to distinguish benign and malignant adnexal masses.

机构信息

Department of Ultrasound, China Medical University, Shengjing Hospital, No. 36 Sanhao Street, Heping District, Shenyang, 110004 Liaoning Province, China.

出版信息

Eur J Radiol. 2023 Aug;165:110926. doi: 10.1016/j.ejrad.2023.110926. Epub 2023 Jun 16.

DOI:10.1016/j.ejrad.2023.110926

PMID:37418798

Abstract

PURPOSE

To compare the diagnostic performance of International Ovarian Tumour Analysis Simple Rules (IOTA SR) and Ovarian-Adnexal Reporting and Data System (O-RADS), and to analyse whether combining IOTA SR and O-RADS with the biomarkers cancer antigen 125 (CA125), human epididymis protein 4 (HE4), and risk of malignancy algorithm (ROMA) further improves diagnostic performance in women with different menopause status.

METHODS

This study retrospectively included patients with ovarian adnexal masses confirmed by surgical pathology between September 2021 and February 2022. The area under the curve (AUC), sensitivity, and specificity were calculated to evaluate the diagnostic efficacy of IOTA SR, O-RADS, and their combination with CA125, HE4, and ROMA.

RESULTS

This study included 1,179 ovarian adnexal masses. In all women, the AUC of IOTA SR was comparable to O-RADS (0.879 vs. 0.889, P = 0.361), and O-RADS had a significantly higher sensitivity than IOTA SR (95.77 % vs. 87.32 %, P < 0.001). In premenopausal women, O-RADS had a significantly higher AUC than other diagnostic strategies (all P < 0.05), and the sensitivity, specificity, and accuracy were 93.33 %, 84.74 %, and 85.59 %, respectively. In postmenopausal women, IOTA SR + ROMA had a significantly higher AUC than other diagnostic strategies (all P < 0.05), and the sensitivity, specificity, and accuracy were 85.37 %, 93.88 %, and 90.00 %, respectively.

CONCLUSIONS

Our study supports the high diagnostic value of IOTA SR or O-RADS alone in all women, and O-RADS was more sensitive than IOTA SR. In premenopausal women, O-RADS had the highest diagnostic value. In postmenopausal women, IOTA SR outperformed O-RADS, and IOTA SR + ROMA had the highest diagnostic value.

摘要

目的

比较国际卵巢肿瘤分析简单规则（IOTA SR）和卵巢-附件报告和数据系统（O-RADS）的诊断性能，并分析将 IOTA SR 和 O-RADS 与生物标志物癌抗原 125（CA125）、人附睾蛋白 4（HE4）和恶性风险算法（ROMA）相结合是否能进一步提高不同绝经状态女性的诊断性能。

方法

本研究回顾性纳入 2021 年 9 月至 2022 年 2 月间经手术病理证实为卵巢附件肿块的患者。计算曲线下面积（AUC）、敏感度和特异度，以评估 IOTA SR、O-RADS 及其与 CA125、HE4 和 ROMA 结合的诊断效果。

结果

本研究共纳入 1179 例卵巢附件肿块。在所有女性中，IOTA SR 的 AUC 与 O-RADS 相当（0.879 比 0.889，P=0.361），O-RADS 的敏感度明显高于 IOTA SR（95.77%比 87.32%，P<0.001）。在绝经前女性中，O-RADS 的 AUC 明显高于其他诊断策略（均 P<0.05），其敏感度、特异度和准确率分别为 93.33%、84.74%和 85.59%。在绝经后女性中，IOTA SR+ROMA 的 AUC 明显高于其他诊断策略（均 P<0.05），其敏感度、特异度和准确率分别为 85.37%、93.88%和 90.00%。