以血清CA125、绝经状态和超声检查评分预测卵巢肿瘤患者术前恶性危险指数

目的：评价以血清CA125、绝经状态和超声评分对卵巢肿瘤患者术前恶性危险指数的预测。方法：分别计算血清CA125、绝经状态、超声评分和3者结合的恶性危险指数（RMI）RMI-1和RMI-2，用以诊断卵巢癌的敏感性、特异性和阳性预测值等。结果：随机测定卵巢良性肿瘤76例和恶性肿瘤37例。若以100为RMI的界值，RMI-1的敏感性、特异性分别为81.1%和93.4%。RMI-2分别为81.0%和89.5%。若以125为RMI界值，RMI-1的敏感性、特异性为78.3%和96.0%，RMI-2分别为81.0%和90.8%。RMI-1的诊断性能明显高于RMI-2。RMI的诊断准确性明显比CA125、绝经状态、超声评分单项者高，且可与其它评分方法相媲美。结论：RMI是术前比较简单、可靠、实用的鉴别诊断卵巢肿瘤性质的方法。

Evaluation of the risk of malignancy index based on serum CA125,menopausal status a nd ultrasoun d score for forecast the patients with ovarian tumors.

Objective:To evaluate the risk of malignancy indices(RMI- 1 and RMI-2)based on serum CA125,menopausal status,and ultrasound score for forecast t he patients with ovarian tumors.Methods:The sensitivity,specific ity,positive predictive value of serum CA125,ultrasound scores and menopausal st a tus, separately and combined into the RMI-1 andRMI-2,for differential diagnosis of ovarian tumors. Results:Benign ovarian tumors 76 cases and ovar i an cancers 37cases were randomly measured.The RMI-1 at a cut off value of 100 gave a sensitivity of 81.1％，specificity of 93.4％.A sensitivity of 78.3％, specificity of 96.0％ were given at a cut off value of 125.RMI-2 gave a sen sitiv ity of 81.0％,specificity of 89.5％ and 78.3％,90.8％ respectively. For all cut of f values between 50 and 200,RMI-1 performed better than that of RMI-2.RMI was mo re accurate than menopausal status, ultrasound score ,and serum CA125 separately in diagnosing ovarian tumors, and was comparable with other scoring systems. Conclusions:RMI-1 is more reliable in discriminating benign and mal ig nant ovarian tumors than that of RMI-2.RMI is a simple,practical and reliable me thod which can be used in gynecologic clinics.