| Objective: To explore the value of Finkler ultrasonic score,blood flow parameters and tumor markers in the diagnosis of benign and malignant ovarian tumors,in order to find the clues of ultrasonography and tumor markers in the classification of ovarian tumors,To provide clinical basis for ovarian cancer patients with imaging and prognostic evaluation provide a reliable standard.Methods: The retrospective analysis of preoperative ultrasound findings and tumor marker HE4 test results for 80.12 cases of ovarian tumors confirmed by postoperative pathology in our hospital from 2016.12-2018.1 month was performed.The ultrasound examination results were scored according to the Finkler ultrasound scoring criteria.The score was greater than or equal to 7 were divided into malignant group and less than 7 points were classified as benign group;according to the color Doppler ultrasound index of resistance,below 0.43 was classified as malignant group,and higher than 0.43 was classified as benign;HE4 value in tumor markers The malignant group was greater than 150 pmol/L,and the benign group was less than or equal to 150 pmol/L.In the three groups of joint examinations,the logistic regression model was used to obtain the best joint predictor.The postoperative pathology was used as the final diagnostic criteria to calculate the accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of each test and the combination of the three tests,and the Youden index was calculated.Draw a ROC graph and analyze it based on the area under the curve and the Yodner index.Results: A total of 80 cases of ovarian cancer patients,malignant 23 cases,57 cases of benign.According to the diagnostic criteria of Finkler ultrasound,31 cases were malignant and 49 cases were benign.According to RI diagnostic criteria,28 cases were malignant and 52 cases were benign.According to the diagnostic criteria of serum tumor marker HE4,26 cases were malignant and 54 cases were benign.Finkler score+RI+HE4 detected 26 malignant cases and 54 benign cases.The accuracy of Finkler ultrasound score was 82.50%(66/80),sensitivity was 86.96%(20/23),specificity was 80.70%(46/57).Positive predictive value was 64.52%(20/31),negative predictive value was 93.88%(46/49),Youden index was 0.68,area under ROC curve was 0.857,and 95% confidence interval(0.763-0.950).The accuracy of the RI results was 82.50%(69/80),the sensitivity was 86.96%(20/23),the specificity was 85.96%(49/57),the positive predictive value was 71.43%(20/28),and the negative predictive value was 94.23%(49/52),Youden index was 0.73,area under ROC curve was 0.820,95% confidence interval(0.725-0.934).The accuracy of HE4 results was 87.50%(70/80),sensitivity was 78.26%(18/23),specificity was 91.23%(52/57),positive predictive value was 78.26%(18/23),and negative predictive value was 91.23%(52/57),Youden index 0.69,area under ROC curve 0.881,95% confidence interval(0.787-0.974).The accuracy of the Finkler score+RI+HE4 was 93.75(75/80),the sensitivity was 95.65%(22/23),the specificity was 92.98%(53/57),and the positive predictive value was 84.61%(22/26).The value was 98.15%(53/54),Youden index was 0.92,and the area under the ROC curve was 0.924,95% confidence interval(0.862-0.985).Conclusions: The Finkler ultrasound score and RI can diagnose benign and malignant ovarian tumors to a certain extent.It has positive value and can be used as the main screening method in screening.However,its accuracy is low,and combined HE4 examination can improve accuracy and identify early It has a great advantage in diagnosing ovarian tumors. |
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