To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from Se...To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from September 2014 to November 2016.Age,menopausal status,histopathology,the International Federation of Gynecology and Obstetrics(FIGO)stages,tumor biomarker levels,and detailed ultrasound reports of patients were collected.The area under the curve(AUC),sensitivity,and specificity of the bellow-mentioned predictors were analyzed using the receiver operating characteristic curve.Of the 719 patients,531 had benign lesions,119 had epithelial ovarian cancers(EOC),44 had borderline ovarian tumors(BOT),and 25 had non-EOC.AUCs and the sensitivity of cancer antigen 125(CAI25),human epididymis-specific protein 4(HE4),Risk of Ovarian Malignancy Algorithm(ROMA),Risk of Malignancy Index(RMI1),HE4 model,and Rajavithi-Ovarian Cancer Predictive Score(R-OPS)in the overall population were 0.792,0.854,0.856,0.872,0.893,0.852,and 70.2%,56.9%,69.1%,60.6%,77.1%,71.3%,respectively.For distinguishing EOC from benign tumors,the AUCs and sensitivity of the above mentioned predictors were 0.888,0.946,0.947,0.949,0.967,0.966,and 84.0%,79.8%,87.4%,84.9%,90.8%,89.1%,respectively.Their specificity in predicting benign diseases was 72.9%,94.4%,87.6%,95.9%,86.3%,90.8%,respectively.Therefore,we consider biomarkers in combination with ultrasound features may improve the diagnostic performance in distinguishing malignant from benign ovarian tumors.展开更多
Objective To evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass. Methods One hundred and ...Objective To evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass. Methods One hundred and forty women with pelvic masses, at age 30 of years or more were admitted to the Peking Union Medical College Hospital between January 1998 and June 1999. The sensitivity, specificity and positive predictive value of serum CA125 level, ultrasound findings and the menopausal status in diagnosis of ovarian cancer were evaluated separately or combined into the RMI. Results RMI was more accurate than any individual criterion in diagnosing cancer. Using an RMI cutoff level of 200 to indicate malignancy, the RMI derived from this data set gave a sensitivity of 87.3%, a specificity of 84.4%, and a positive predictive value of 82.1%. Conclusions RMI is able to correctly discriminate malignant from benign pelvic mass. It can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery.展开更多
Objective:To study the value of serum tumor markers, carbohydrate antigen 125 (CA125), human epididymis secretory protein 4 (HE4) and ovarian cancer risk factor (ROMA) index in elderly patients with ovarian cancer, so...Objective:To study the value of serum tumor markers, carbohydrate antigen 125 (CA125), human epididymis secretory protein 4 (HE4) and ovarian cancer risk factor (ROMA) index in elderly patients with ovarian cancer, so as to provide a choice for clinical diagnosis.Methods:A total of 110 cases of ovarian cancer treated in our hospital in December 2017-December 2015 were selected as malignant group. In addition, 120 cases of benign ovarian tumors in the same period were selected as the benign group, and 92 healthy women who came to the hospital for health examination were selected as the control group. Serum HE4, CA125 levels and positive rates were detected by microparticle enzyme immunochemiluminescence assay, and ROMA index values were combined to assess the risk of ovarian cancer.Results:Malignant group serum CA125, HE4 level and ROMA index were significantly higher than those in the benign group and the control group, the level of CA125 in positive group was higher than control group, but the difference in level of HE4 and ROMA index between benign group and control group was not statistically significant. The positive rates of serum CA125, HE4 and ROMA index in malignant group were 76.4%, 92.7%, 96.4%, which were significantly higher than those in benign group (28.3%, 18.3%, 15%). The negative predictive value, positive predictive value, specificity and sensitivity of CA125 were all lower than those of HE4. The negative predictive value, positive predictive value, specificity and sensitivity of the combined ROMA index were higher than those of single diagnosis.Conclusions: Serum CA125, HE4 and ROMA index in elderly patients with ovarian cancer are significantly higher than those in elderly patients with benign ovarian tumors and healthy women. The combined diagnosis is the highest, with Gao Min's high sensitivity and specificity, which can be popularized in clinical practice.展开更多
目的评价CA125、超声检查、恶性风险指数-3(risk of malignancy index,RMI-3)及恶性风险指数-4(RMI-4)对绝经后卵巢肿瘤的诊断价值。方法回顾性分析2008年1月至2010年2月复旦大学附属妇产科医院手术治疗的绝经后卵巢肿瘤患者186例,比较...目的评价CA125、超声检查、恶性风险指数-3(risk of malignancy index,RMI-3)及恶性风险指数-4(RMI-4)对绝经后卵巢肿瘤的诊断价值。方法回顾性分析2008年1月至2010年2月复旦大学附属妇产科医院手术治疗的绝经后卵巢肿瘤患者186例,比较超声检查、CA125水平及2种RMI对附件肿块良恶性判断的敏感性和特异性。结果 4种指标的敏感性分别为90.7%、54.9%、83.7%和84.9%,特异性分别为93.7%、78.9%、96.8%和93.7%,约登指数(Youden index,YI)分别为0.84、0.34、0.81和0.78。四者的诊断效能两两相比,差异均有统计学意义(P=0.00)。造成各指标假阴性的病例以上皮性肿瘤为主,造成假阳性的病例以性索间质肿瘤为主。结论本研究发现目前2种RMI对绝经后卵巢肿瘤诊断的敏感性及YI均低于血清CA125。鉴于绝经后卵巢肿瘤的特殊性,可能需进一步评估CA125在绝经后卵巢肿瘤中的重要性以提高RMI对其的诊断效能。展开更多
基金grants from Guangdong Science and Technology Department of China(No.2016A020215115)Science and Technology Bureau of Tianhe District,Guangzhou,Guangdong(No.201604KW010)Science and Technology Bureau of Huadu District,Guangzhou,Guangdong(No.HD15CXY006).
文摘To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from September 2014 to November 2016.Age,menopausal status,histopathology,the International Federation of Gynecology and Obstetrics(FIGO)stages,tumor biomarker levels,and detailed ultrasound reports of patients were collected.The area under the curve(AUC),sensitivity,and specificity of the bellow-mentioned predictors were analyzed using the receiver operating characteristic curve.Of the 719 patients,531 had benign lesions,119 had epithelial ovarian cancers(EOC),44 had borderline ovarian tumors(BOT),and 25 had non-EOC.AUCs and the sensitivity of cancer antigen 125(CAI25),human epididymis-specific protein 4(HE4),Risk of Ovarian Malignancy Algorithm(ROMA),Risk of Malignancy Index(RMI1),HE4 model,and Rajavithi-Ovarian Cancer Predictive Score(R-OPS)in the overall population were 0.792,0.854,0.856,0.872,0.893,0.852,and 70.2%,56.9%,69.1%,60.6%,77.1%,71.3%,respectively.For distinguishing EOC from benign tumors,the AUCs and sensitivity of the above mentioned predictors were 0.888,0.946,0.947,0.949,0.967,0.966,and 84.0%,79.8%,87.4%,84.9%,90.8%,89.1%,respectively.Their specificity in predicting benign diseases was 72.9%,94.4%,87.6%,95.9%,86.3%,90.8%,respectively.Therefore,we consider biomarkers in combination with ultrasound features may improve the diagnostic performance in distinguishing malignant from benign ovarian tumors.
文摘Objective To evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass. Methods One hundred and forty women with pelvic masses, at age 30 of years or more were admitted to the Peking Union Medical College Hospital between January 1998 and June 1999. The sensitivity, specificity and positive predictive value of serum CA125 level, ultrasound findings and the menopausal status in diagnosis of ovarian cancer were evaluated separately or combined into the RMI. Results RMI was more accurate than any individual criterion in diagnosing cancer. Using an RMI cutoff level of 200 to indicate malignancy, the RMI derived from this data set gave a sensitivity of 87.3%, a specificity of 84.4%, and a positive predictive value of 82.1%. Conclusions RMI is able to correctly discriminate malignant from benign pelvic mass. It can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery.
文摘Objective:To study the value of serum tumor markers, carbohydrate antigen 125 (CA125), human epididymis secretory protein 4 (HE4) and ovarian cancer risk factor (ROMA) index in elderly patients with ovarian cancer, so as to provide a choice for clinical diagnosis.Methods:A total of 110 cases of ovarian cancer treated in our hospital in December 2017-December 2015 were selected as malignant group. In addition, 120 cases of benign ovarian tumors in the same period were selected as the benign group, and 92 healthy women who came to the hospital for health examination were selected as the control group. Serum HE4, CA125 levels and positive rates were detected by microparticle enzyme immunochemiluminescence assay, and ROMA index values were combined to assess the risk of ovarian cancer.Results:Malignant group serum CA125, HE4 level and ROMA index were significantly higher than those in the benign group and the control group, the level of CA125 in positive group was higher than control group, but the difference in level of HE4 and ROMA index between benign group and control group was not statistically significant. The positive rates of serum CA125, HE4 and ROMA index in malignant group were 76.4%, 92.7%, 96.4%, which were significantly higher than those in benign group (28.3%, 18.3%, 15%). The negative predictive value, positive predictive value, specificity and sensitivity of CA125 were all lower than those of HE4. The negative predictive value, positive predictive value, specificity and sensitivity of the combined ROMA index were higher than those of single diagnosis.Conclusions: Serum CA125, HE4 and ROMA index in elderly patients with ovarian cancer are significantly higher than those in elderly patients with benign ovarian tumors and healthy women. The combined diagnosis is the highest, with Gao Min's high sensitivity and specificity, which can be popularized in clinical practice.