Diagnostic efficiency of IOTA ADNEX model and IOTA simple rules in women with indeterminate adnexal masses

doi:10.3877/cma.j.issn.1672-6448.2020.11.005

Abstract

Abstract:

Objective

To evaluate the diagnostic efficiency of ADNEX (Assessment of Different NEoplasias in the adneXa) model, simple rules (SR) developed by the International Ovarian Tumor Analysis (IOTA) and subjective assessment (SA) in adnexal lesions with an unclear clinical diagnosis.

Methods

Patients who had indeterminate adnexal masses and would undergo surgical treatment were prospectively collected at the gynecological tumor clinic of Peking Union Medical College Hospital from March 2018 to August 2019. Transvaginal ultrasound, if necessary, combined with transabdominal ultrasound was conducted. Ultrasound diagnosis was made by using the IOTA-ADNEX model, SR, and SA, separately. According to the results of surgical pathology, the patients were divided into benign and malignant groups. ROC curve of the ADNEX model was plotted. The diagnostic efficiencies of IOTA-ADNEX model, SR, and SA were calculated.

Results

A total of 53 patients with 58 adnexal masses were enrolled in the study. SR was suitable for 89.7% of adnexal masses. The area under the ROC curve of the ADNEX model was 0.819 (95%CI: 0.701-0.936), the Youden index was 0.639, and the cut-off value was 36.2%. The diagnostic accuracy of the ADNEX model was 82.8%, which was higher than that of SR (69.0%) and similar to that of SA (84.5%). ADNEX model had the highest diagnostic sensitivity (87.9%), followed by SR (84.8%) and SA (81.8%). SA had the highest diagnostic specificity (88.0%), followed by ADNEX (76.0%) and SR (48.0%).

Conclusion

IOTA ADNEX model and SR are effective in the differentiation between benign and malignant adnexal masses in difficult cases.

Key words: ADNEX model, Diagnosis, Ovarian cancer, Ultrasonography

Zhenzhen Liu, Zhimin Shi, Zhonghui Xu, Jianchu Li, Yuxin Jiang. Diagnostic efficiency of IOTA ADNEX model and IOTA simple rules in women with indeterminate adnexal masses[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(11): 1084-1089.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.11.005

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I11/1084

Figures/Tables 7

References 12

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组别	例数	年龄（岁，±s）	绝经前[例（%）]	绝经后[例（%）]	糖链抗原-125（U/ml）	病变最大径（mm，±s）
全组	53	47±14	34（57.6）	19（42.4）	54.0（15.5，254.0）	77.7±39.1
良性组	24	45±15	15（62.5）	9（37.5）	16.0（11.5，51.5）	69.8±31.0
恶性组	29	48±14	19（65.5）	10（34.5）	131.0（58.8，539.5）	83.7±43.8
统计值		t=0.605	χ²=0.052		Z=86.000	t=1.353
P值		0.548	0.820		<0.001	0.182

组别	例数	年龄（岁，±s）	绝经前[例（%）]	绝经后[例（%）]	糖链抗原-125（U/ml）	病变最大径（mm，±s）
全组	53	47±14	34（57.6）	19（42.4）	54.0（15.5，254.0）	77.7±39.1
良性组	24	45±15	15（62.5）	9（37.5）	16.0（11.5，51.5）	69.8±31.0
恶性组	29	48±14	19（65.5）	10（34.5）	131.0（58.8，539.5）	83.7±43.8
统计值		t=0.605	χ²=0.052		Z=86.000	t=1.353
P值		0.548	0.820		<0.001	0.182

病理类型		包块数（个）	百分比（%）
良性		25	43.1
	卵巢黄素化滤泡囊肿	1	1.7
	内膜异位症囊肿	4	6.9
	浆液性/黏液性囊腺瘤	3	5.2
	畸胎瘤	3	5.2
	卵巢甲状腺肿	2	3.4
	硬化性间质瘤	2	3.4
	脂质细胞瘤	1	1.7
	附件区炎性病变	6	10.3
	其他	3	5.2
恶性		33	56.9
	交界性肿瘤	10	17.2
	浆液性癌/浆黏液性癌	13	22.4
	子宫内膜样癌	5	8.6
	透明细胞癌	2	3.4
	颗粒细胞瘤	1	1.7
	转移癌	2	3.4

病理类型		包块数（个）	百分比（%）
良性		25	43.1
	卵巢黄素化滤泡囊肿	1	1.7
	内膜异位症囊肿	4	6.9
	浆液性/黏液性囊腺瘤	3	5.2
	畸胎瘤	3	5.2
	卵巢甲状腺肿	2	3.4
	硬化性间质瘤	2	3.4
	脂质细胞瘤	1	1.7
	附件区炎性病变	6	10.3
	其他	3	5.2
恶性		33	56.9
	交界性肿瘤	10	17.2
	浆液性癌/浆黏液性癌	13	22.4
	子宫内膜样癌	5	8.6
	透明细胞癌	2	3.4
	颗粒细胞瘤	1	1.7
	转移癌	2	3.4

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