中国现代医学杂志2024，Vol.34Issue(13)：14-19,6.DOI:10.3969/j.issn.1005-8982.2024.13.003
基于简化流程图的O-RADS联合ADNEX模型评估中老年女性附件肿瘤良恶性的临床应用
Clinical application of simplified flowchart-based O-RADS combined with ADNEX model in evaluating the benign and malignant nature of adnexal tumors in middle-aged and elderly women
摘要
Abstract
Objective To explore the clinical application of the O-RADS combined with the ADNEX model,using a simplified flowchart,in evaluating the benign and malignant nature of adnexal tumors in middle-aged and elderly women.Methods A total of 95 middle-aged and elderly patients with adnexal tumors,detected by gynecological ultrasound and confirmed by surgery at the Affiliated Hospital of Guilin Medical University from November 2018 to November 2022,were selected.The adnexal tumors were classified according to the O-RADS and ADNEX models,with pathological histology serving as the gold standard.The diagnostic performance of the O-RADS,ADNEX model,and their combination was calculated,and the receiver operating characteristic(ROC)curves were plotted.Results Among the 95 patients,46 had malignant tumors and 49 had benign tumors according to the pathological results.The sensitivity,specificity,positive predictive value,and negative predictive value of O-RADS categories 4 and 5 for diagnosing malignant adnexal tumors were 93.48％(95％CI:0.811,0.983),69.39％(95％CI:0.544,0.813),74.14％,and 91.89％,respectively.For the ADNEX model,these values were 89.13％(95％CI:0.756,0.959),79.59％(95％CI:0.652,0.893),80.39％,and 88.63％,respectively.The combined diagnostic sensitivity,specificity,positive predictive value,and negative predictive value of O-RADS and ADNEX were 93.48％(95％CI:0.811,0.983),83.67％(95％CI:0.698,0.922),84.31％,and 93.18％,respectively.The area under the ROC curve for diagnosing the nature of adnexal tumors was 0.814 for O-RADS,0.844 for ADNEX,and 0.871 for their combination.The inter-observer agreement between two ultrasound physicians using O-RADS was excellent(κ=0.847,P=0.000).The time taken to classify using the simplified flowchart was shorter than that using the color-coded scoring table(42 minutes 39 seconds vs.51 minutes 3 seconds).Conclusions The combined use of O-RADS and the ADNEX model offers higher diagnostic value for evaluating adnexal tumors in middle-aged and elderly women compared to using O-RADS alone.There is high consistency between different ultrasound physicians when using O-RADS,and the simplified flowchart allows for quicker classification,making it a valuable method for widespread adoption.关键词
附件肿瘤/卵巢-附件影像报告和数据系统/简化流程图/ADNEX模型/良恶性/中老年女性Key words
adnexal tumor/ovarian-adnexal reporting and data system/simplified flowchart/ADNEX model/benign and malignant/middle-aged and elderly women分类
医药卫生引用本文复制引用
赵薇,李琴..基于简化流程图的O-RADS联合ADNEX模型评估中老年女性附件肿瘤良恶性的临床应用[J].中国现代医学杂志,2024,34(13):14-19,6.基金项目
广西高校中青年教师科研基础能力提升项目(No:2021KY0512) （No:2021KY0512）
广西卫健委自筹科研课题(No:Z20211244) （No:Z20211244）
