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胆囊报告和数据系统联合彩色多普勒血流成像对亚洲人群胆囊癌的诊断性能

Diagnostic performance of the gallbladder reporting and data system combined with color doppler flow imaging for gallbladder cancer in the Asian population.

作者信息

Wang Rongling, Lv Lin, Li Li

机构信息

Department of Ultrasound, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong, China.

出版信息

Front Oncol. 2024 Apr 15;14:1367351. doi: 10.3389/fonc.2024.1367351. eCollection 2024.

Abstract

PURPOSE

Evaluating the performance of the Gallbladder Reporting and Data System (GB-RADS) combined with Color Doppler Flow Imaging (CDFI) for the diagnosis of gallbladder wall thickening disease in an Asian population.

METHODS

In this study, the lesions were classified and the actual incidence rate of malignant tumors was calculated for each GB-RADS category, following the guidelines provided by GB-RADS. To evaluate the diagnostic performance of GB-RADS and GB-RADS combined with CDFI, we plotted Receiver Operator Characteristic (ROC) curves. The sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy (AC) were also calculated. Inter-observer agreement (IRA) between the two observers was assessed using Kappa values.

RESULTS

The incidence of malignancy risk for GB-RADS 2, 3, 4, and 5 was 9%, 12.5%, 72.2%, and 100%. The AUC for GB-RADS was 0.855 (95% CI: 0.800-0.900), with a sensitivity of 82.5%, a specificity of 84.6%, and an accuracy of 83.8%. The AUC of GB-RADS combined with CDFI was 0.965 (95% CI: 0.930-0.985), with a sensitivity of 96.2%, a specificity of 94.6%, and an accuracy of 95.2%. The AUC, sensitivity, specificity, and accuracy of GB-RADS combined with CDFI for diagnosing gallbladder malignancy were higher than those of GB-RADS alone, and the differences were statistically significant (all P < 0.05). The IRA was excellent between the two observers (Kappa = 0.870).

CONCLUSIONS

GB-RADS combined with CDFI demonstrated excellent diagnostic accuracy when it comes to distinguishing various diseases that caused gallbladder wall thickening in the Asian population, which has good clinical value and can improve the detection rate of malignant tumors in patients with gallbladder wall thickening.

摘要

目的

评估胆囊报告和数据系统(GB-RADS)联合彩色多普勒血流成像(CDFI)在亚洲人群胆囊壁增厚疾病诊断中的性能。

方法

在本研究中,按照GB-RADS提供的指南对病变进行分类,并计算每个GB-RADS类别的恶性肿瘤实际发病率。为了评估GB-RADS以及GB-RADS联合CDFI的诊断性能,我们绘制了受试者工作特征(ROC)曲线。还计算了灵敏度(SE)、特异度(SP)、阳性预测值(PPV)、阴性预测值(NPV)和准确度(AC)。使用Kappa值评估两位观察者之间的观察者间一致性(IRA)。

结果

GB-RADS 2、3、4和5类的恶性风险发生率分别为9%、12.5%、72.2%和100%。GB-RADS的曲线下面积(AUC)为0.855(95%置信区间:0.800 - 0.900),灵敏度为82.5%,特异度为84.6%,准确度为83.8%。GB-RADS联合CDFI的AUC为0.965(95%置信区间:0.930 - 0.985),灵敏度为96.2%,特异度为94.6%,准确度为95.2%。GB-RADS联合CDFI诊断胆囊恶性肿瘤的AUC、灵敏度、特异度和准确度均高于单独使用GB-RADS,差异具有统计学意义(均P < 0.05)。两位观察者之间的IRA极佳(Kappa = 0.870)。

结论

GB-RADS联合CDFI在区分亚洲人群中导致胆囊壁增厚的各种疾病方面显示出优异的诊断准确性,具有良好的临床价值,可提高胆囊壁增厚患者恶性肿瘤的检出率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d299/11056497/406bf0440a60/fonc-14-1367351-g001.jpg

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