恶性肿瘤风险指数在卵巢恶性肿瘤术前诊断中的作用

目的 回顾性评价应用血清CA125值、超声分数、绝经状态及恶性肿瘤风险指数（RMI）对卵巢肿物的良、恶性进行预测，探讨卵巢恶性肿瘤的早期诊断。方法 1998年1月至1999年6月，北京协和医院妇科肿瘤病房收治的年龄30岁以上的卵巢肿瘤患者140例，其中77例为良性肿瘤患者，63例为恶性肿瘤患者，分别以其术前血清CA125水平、超声分数、绝经状态，以及RMI，对卵巢肿瘤良、恶性进行预测。比较其敏感性、特异性及阳性预测值。结果 RMI较其他指标对卵巢良、恶性肿瘤的预测更为准确。以RMI200为界，其敏感性为87.3%，特异性为84.4%，阳性预测值为82.1%。结论 RMI较其他指标对卵巢肿瘤良、恶性的预测更为准确且更易被接受，RMI具有较大的临床应用价值。

Effect of a risk of malignancy index in preoperative diagnosis of ovarian cancer

Objective To evaluate the ability of a risk of malignancy index (RMI), based on a serum CA125 level, ultrasound findings and menopausal status,to discriminate a benign from a malignant pelvic mass Methods One hundred and forty women with a pelvic mass, 30 years or older,admitted between January 1998 and June 1999, were studied The sensitivity,specificity and positive predictive value of serum CA125 level, ultrasound findings and the menopausal status separately and combined into the RMI,to diagnose ovarian cancer Results RMI was more accurate than any individual criterion in diagnosing cancer Using a RMI cut off level of 200 to indicate malignancy, the RMI derived from this data set gave a sensitivity of 87 3%, specificity of 84 4%, and positive predictive value of 82 1% Conclusions RMI is able to correctly discriminate between malignant and benign pelvic mass It can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery