实用肿瘤杂志

目的 探讨卵巢-附件影像报告和数据系统（Ovarian-Adnexal Reporting and Data System,O-RADS）分类联合超声造影及血清糖类抗原125(carbohydrate antigen 125,CA125)和人附睾分泌蛋白4(human epididymis protein 4,HE4)在诊断绝经后卵巢肿物中的应用价值。方法 回顾性分析2021年1月至2022年3月在本院收治并经病理证实的76例绝经后妇女卵巢肿物患者。患者术前均行常规超声、超声造影及血清CA125和HE4检查，以病理诊断为金标准，采用受试者工作特征（receiver operating characteristic,ROC）曲线分析常规超声O-RADS分类联合超声造影及血清CA125和HE4指标对绝经后卵巢肿物的诊断价值。结果 76例绝经后卵巢肿物病理诊断良性55例，恶性21例。超声O-RADS分类诊断敏感度、特异度和准确度分别为71.4%、76.4%和75.0%。超声造影显示，卵巢恶性肿物始增时间和达峰时间均低于良性肿物，峰值强度高于良性肿物（均P<0.05）。超声O-RADS分类、超声造影联合血清CA125和HE4检测诊断卵巢良恶性肿物的敏感度、特异度、准确度和曲线下面积（area the under curve,AUC）分别为85.7%、92.7%、90.8%和0.892，高于单一检测技术（均P<0.05）。结论 超声O-RADS分类、超声造影联合血清CA125和HE4检测可提高绝经后卵巢肿物的诊断效能。

Objective To explore the application value of Ovarian-Adnexal Imaging and Data System(O-RADS) classification combined with contrast-enhanced ultrasound and levels of serum carbohydrate antigen 125(CA125) and human epididymis protein 4(HE4) in the diagnosis of postmenopausal ovarian masses. Methods Retrospective analysis was conducted on 76 postmenopausal women with ovarian masses confirmed by pathology who were admitted to our hospital from January 2021 to March 2022. All patients underwent routine ultrasound, contrast-enhanced ultrasound, and serum CA125 and HE4 detection before surgery. Pathological diagnosis was used as the gold standard, and the receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of routine ultrasound O-RADS classification combined with contrast-enhanced ultrasound and serum CA125 and HE4 indicators for postmenopausal ovarian masses. Results Pathological diagnosis of 76 postmenopausal ovarian masses included 55 cases of benign masses and 21 cases of malignant masses.The sensitivity, specificity, and accuracy of ultrasound O-RADS classification diagnosis were 71.4%, 76.4%, and 75.0%, respectively.Contrast-enhanced ultrasound showed that the onset time and peak time of malignant ovarian tumors were lower than those of benign tumors, and the peak intensity was higher than that of benign tumors(all P<0.05). The sensitivity, specificity, accuracy, and area under the curve(AUC) of ultrasound O-RADS classification combined with contrast-enhanced ultrasound and levels of serum CA125 and HE4 in the diagnosis of benign and malignant ovarian tumors were 85.7%, 92.7%, 90.8%, and 0.892, respectively, which were higher than those of single detection technique(all P<0.05). Conclusions Ultrasound O-RADS classification combined with contrast-enhanced ultrasound and serum CA125 and HE4 levels can improve the diagnostic efficiency of postmenopausal ovarian masses.