【摘要】 目的 评估术前血清中炎症、凝血、肿瘤标志物指标及超声特征在交界性卵巢肿瘤(BOT)和上皮性卵巢癌(EOC)中的差异，探讨术前血清指标联合超声特征对BOT和EOC的鉴别诊断价值。方法 收集2018年8月—2023年12月于山西医科大学第一医院接受手术且术后病理证实为BOT和EOC的患者224例(BOT组112例，EOC组112例)进行回顾性分析。比较两组患者术前血清指标及超声特征的差异，采用二元Logistic回归分析确定可鉴别BOT和EOC的独立因素，绘制受试者工作特征曲线(ROC)判断术前血清指标和(或)超声特征联合鉴别BOT和EOC的能力。结果 多因素Logistic回归分析结果表明超声特征中有无乳头、间隔、血流信号及血清指标中血小板(Plt)、淋巴细胞(L)、单核细胞/淋巴细胞比值(MLR)、全身免疫炎症指数(SII)、纤维蛋白原(Fib)、ROMA是术前鉴别BOT和EOC的独立因素(P<0.05); ROC曲线得出，血清指标联合鉴别中ROMA+SII+Fib+MLR+Plt+L组合的AUC最大且特异度和阳性预测值(PPV)最高;血清指标与超声特征联合鉴别中上述独立影响指标全部纳入组合的AUC最大为0.930，敏感度和阴性预测值(NPV)最高且均大于90%,ROMA+SII+Fib+MLR+Plt+L+有无血流信号+有无间隔这一组合很好的平衡了敏感度、特异度、PPV和NPV，均为85.7%。结论 术前血清指标及超声特征在BOT与EOC之间存在显著差异，术前血清指标ROMA、SII、Fib、MLR、Plt、L联合超声特征中有无乳头、间隔、血流信号可用于BOT和EOC的术前鉴别且具有良好的诊断效能，有助于为术前临床诊断提供参考。更多还原

【Abstract】 Objective To evaluate the differences in preoperative serummarkers of inflammation,coagulation,tumor biomarkers and ultrasound characteristics between borderline ovarian tumors( BOT) and epithelial ovarian cancer( EOC),and to explore the diagnostic value of combining preoperative serum markers with ultrasound characteristics in the differential diagnosis of BOT and EOC. Methods A retrospective analysis was conducted among 224 patients who underwent surgery in the First Hospital of Shanxi Medical University from August 2018 to December 2023 and were pathologically confirmed( 112 cases in BOT group,112 cases in EOC group). The differences in preoperative serum markers and ultrasonic features between the two groups were compared. Binary logistic regression analysis was used to identify independent factors for differentiating BOT from EOC. Receiver operating characteristic( ROC) curves were plotted to assess the ability of preoperative serum markers and/or ultrasonic features to differentiate BOT from EOC. Results Multivariate logistic regression analysis revealed that the presence of papillary projections,septations,blood flow signals on ultrasonic features,and serum markers including platelets( Plt),lymphocytes( L),monocyte-to-lymphocyte ratio( MLR),systemic immune-inflammation index( SII),fibrinogen( Fib),and ROMA were independent factors for preoperative differentiation between BOT and EOC( P < 0. 05). The ROC curve analysis indicated that the combination of ROMA +SII + Fib + MLR + Plt + L had the highest area under the curve( AUC) and the highest specificity and positive predictive value( PPV) in the combined serum marker differentiation. The combination of all the above independent factors along with ultrasonic features yielded the highest AUC of 0. 930 for the combined differentiation,with the highest sensitivity and negative predictive value( NPV),both exceeding 90%. The combination of ROMA + SII + Fib + MLR + Plt +L + presence of blood flow signals + presence of septations balanced sensitivity,specificity,PPV,and NPV well,all at85. 7%. Conclusion Significant differences in preoperative serum markers and ultrasonic features exist between BOT and EOC. The combination of preoperative serum markers ROMA,SII,Fib,MLR,Plt,L,and ultrasonic features such as the presence of papillary projections,septations,and blood flow signals can be used for the preoperative differentiation of BOT and EOC with good diagnostic efficacy,which may provide a reference for preoperative clinical diagnosis.更多还原