超声形态积分与CA125对卵巢肿瘤诊断价值的ROC曲线分析

目的:用接受器工作特性(ROC)曲线分析评价超声形态积分(SMS)及CA125对卵巢肿瘤的诊断价值.方法:回顾性分析105例住院患者手术、超声等临床资料,术前计算SMS,检测血清CA125；SMS范围1～10,由肿瘤体积积分和结构积分组成.与术后病理对照,绘制ROC曲线,确定最佳截断值.结果:ROC结果显示,SMS诊断卵巢肿瘤的ROC曲线下面积为0.866,CA125诊断卵巢肿瘤的ROC曲线下面积为0.878,z=0.52,P＞0.05.以5为截断值,SMS 诊断卵巢肿瘤的敏感性88.06％,特异性68.42％,阳性预测值83.10％,阴性预测值76.47％;以35 U/ml.为截断值,CA125诊断卵巢肿瘤的敏感性85.07％,特异性71.05％,阳性预测值83.82％,阴性预测值72.94％.结论:SMS与CA125诊断卵巢肿瘤的ROC曲线下面积差异无统计学意义,两者均是诊断卵巢肿瘤的有效方法.

Receiver operating characteristic curve analysis for diagnosing ovarian tumors by sonographic morphology scores and CA125

OBJECTIVE: To determine the efficacy of sonographic morphology scores(SMS) and CA125 test to diagnose ovarian tumors by receiver operating characteristic(ROC) curve.METHODS: Preoperative data including ultrasound and blood assays in 105 patients with ovarian tumors were assessed using SMS-a score of 1 to 10 based on volume and morphologic complexity and CA125 level tested.The final diagnosis was based on the pathological findings.The ROC curve was drawn to determine the optimum cut-off value.RESULTS: Area under the ROC curve of SMS for ovarian tumors was 0.866,and area under the ROC curve of CA125 was 0.878.By z test,there was no significant difference between SMS and CA125 in the diagnosis of ovarian tumors(z=0.52,P>0.05).With a cut-off value of 5,the sensitivity,specificity,PPV,and NPV of SMS were 88.06%,68.42%,83.10% and 76.47% respectively.With a cut-off value of 35 U/mL,the sensitivity,specificity,PPV,and NPV of CA125 were 85.07%,71.15%,83.82% and 72.94% respectively.CONCLUSION: The sonographic morphology scores,as well as CA125 test,is an accurate and simple method to diagnose ovarian tumor due to no significant difference in their area under the ROC curve.