| Objective :Uterine sarcoma is a rare gynecological malignant tumor in clinic.Due to the lack of tumor markers and imaging methods with high specificity at present,early preoperative diagnosis is very difficult,and it is often misdiagnosed as uterine fibroids,leading to delayed disease or improper selection of surgical methods and multiple surgical trauma,which seriously affects the prognosis and quality of life of patients.In addition,the uterine sarcoma preoperative prediction and scoring system proposed in the expert consensus has shortcomings such as strong subjectivity and lack of quantification.Therefore,this paper established the uterine sarcoma ultrasonic screening and scoring system through statistical analysis of multiple ultrasonic parameters in the uterine sarcoma group and the uterine fibroid group.To investigate the diagnostic value of uterine sarcoma ultrasound screening scoring system in benign and malignant risk stratification of uterine tumors,in order to improve the accuracy of preoperative ultrasonic diagnosis of uterine sarcoma.Methods:Patients diagnosed with myoma of uterus in Maternal and Child Health Hospital of Gansu Province from March 2016 to March 2022 were selected as research objects.The case group consisted of 67 patients with uterine sarcoma pathology,and the control group consisted of 136 patients with uterine fibroids pathology.Ultrasonic signs closely related to uterine sarcoma were screened out by univariate analysis and multivariate logistic regression analysis,and the ultrasonic screening scoring system for uterine sarcoma was established.The diagnostic value of the scoring system was evaluated using receiver operating characteristic curve(ROC curve),and the advantages and disadvantages of the two scoring systems in predicting uterine sarcoma were analyzed by diagnostic consistency.Results:(1)Relevant ultrasonic characteristic parameters of the two groups were analyzed.Age,internal blood flow,peripheral blood flow,isolation,cystic degeneration,internal echo,internal echo and maximum tumor diameter compared with muscular layer were statistically different between the case group and control group(P < 0.05).(2)A scoring system for ultrasonic screening of uterine sarcoma was further developed.The score of the scoring system was 0-14 points.8.5 was selected as the optimal cut-off value according to the ROC curve,and the area under the ROC curve was 0.963(95%CI[0.940,0.985]).Specificity,sensitivity and accuracy were 88.2%,94% and 90.14%,respectively.According to expert consensus,the area under ROC curve of the preoperative prediction scoring system for uterine sarcoma was 0.929(95%CI [0.895,0.962]),and the specificity,sensitivity and accuracy were 95.6%,67.2% and 87.19%,respectively.(3)The diagnostic efficiency of the ultrasonic screening scoring system for uterine sarcoma was improved,and the proportion of correct classification was increased by 18.04%;(4)Comparing the final results of the diagnosis of junior and senior residents using different scoring systems,The Kappa values of preoperative prediction score system for uterine sarcoma and ultrasonic screening score system for uterine sarcoma were 0.668 and 0.767,respectively,with P < 0.01.Conclusions:The diagnostic efficacy of ultrasonic screening scoring system for uterine sarcoma is higher,and the accuracy is better than the expert consensus of uterine sarcoma preoperative prediction scoring system.The ultrasonic screening scoring system for uterine sarcoma can well stratify the sexual and malignant risk of patients with uterine tumor,and can provide a preliminary basis for the ultrasonic differential diagnosis of uterine sarcoma and uterine fibroids.The diagnosis consistency of uterine sarcoma ultrasound screening scoring system applied by different doctors is high,which is suitable for popularization. |
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