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第46卷第8期                           南京医科大学学报(自然科学版)
                  2026年8月                   Journal of Nanjing Medical University(Natural Sciences)     ·1131 ·


               ·专题研究:肿瘤·

                哥本哈根指数对超声O⁃RADS 分类及IOTA 简单法则诊断附件

                良恶性肿块的附加价值



                姜永玲 ,周 建 ,陈丽娟 ,李 奥 ,胡 彧                  3*
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                安徽医科大学附属滁州医院(滁州市第一人民医院)超声科,妇产科,安徽                          滁州   239000;南京医科大学第一附属医院超声
                1                                             2                       3
                医学科,江苏 南京 210029

               [摘   要] 目的:探讨哥本哈根指数(Copenhagen index,CPH⁃I)对超声卵巢⁃附件影像报告和数据系统(ovarian⁃adnexal reports
                and data systems,O⁃RADS)分类及国际卵巢肿瘤研究组(the International Ovarian Tumor Analysis,IOTA)简单法则诊断附件良恶
                性肿块的附加价值。方法:回顾性分析2023年10月—2025年10月在安徽省滁州市第一人民医院经病理结果证实的179例附
                件肿块的常规超声声像图,分别使用O⁃RADS分类和IOTA简单法则对附件肿块进行分类,计算CPH⁃I。以病理结果为金标准,
                根据约登指数取得各诊断方法的最佳截断值。比较两种超声模型单独使用及分别联合CPH⁃I后对附件良恶性肿块的诊断效
                能。将O⁃RADS 4类肿块和IOTA简单法则不确定性肿块分别与CPH⁃I联合,计算其诊断效能。采用DeLong检验比较各模型
                的受试者工作特征曲线的曲线下面积(area under the curve,AUC)。结果:O⁃RADS 分类诊断的最佳截断值为 O⁃RADS 4 类,
                IOTA简单法则诊断的最佳截断值为不确定性肿块,CPH⁃I 诊断的最佳截断值为-2.165。O⁃RADS 分类、IOTA 简单法和CPH⁃I
                诊断附件肿块的AUC分别为0.866、0.926、0.886。两种超声模型分别联合CPH⁃I后诊断的AUC为0.861、0.902。将CPH⁃I单独
                应用于 O⁃RADS 4 类肿块和 IOTA 简单法则不确定性肿块时,AUC 分别为 0.933、0.941,均高于两种超声模型单独诊断的 AUC
               (P=0.022,P=0.562)。结论:CPH⁃I 对 O⁃RADS 分类和 IOTA 简单法则诊断附件肿块具有较好的附加价值,特别是将其运用于
                O⁃RADS 4类肿块和IOTA简单法则不确定性肿块时诊断性能最佳。
               [关键词] 超声诊断;附件肿块;哥本哈根指数;卵巢⁃附件影像报告和数据系统;国际卵巢肿瘤研究组简单法则
               [中图分类号] R445.1;R737.3            [文献标志码] A                      [文章编号] 1007⁃4368(2026)08⁃1131⁃06
                doi:10.7655/NYDXBNSN251443


                The added value of Copenhagen index to O⁃RADS and IOTA simple rules in the diagnosis

                of adnexal masses
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                JIANG Yongling ,ZHOU Jian ,CHEN Lijuan ,LI Ao ,HU Yu 3*
                1 Department of Ultrasound,Department of Gynaecology and Obstetrics,the Affiliated Chuzhou Hospital of Anhui
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                Medical University(the First People’s Hospital of Chuzhou),Chuzhou 239000;Department of Medical Ultrasound,
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                the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
               [Abstract] Objective:To explore the added value of the Copenhagen index(CPH⁃I)in the diagnosis of adnexal masses with ovarian⁃
                adnexal reports and data systems(O ⁃ RADS)and the International Ovarian Tumor Analysis(IOTA)simple rules. Methods:The
                ultrasound images of 179 adnexal masses confirmed by pathological results were analyzed retrospectively in the First People’s Hospital
                of Chuzhou,Anhui from October 2023 to October 2025. The O⁃RADS classification and IOTA simple rule were used for classification
                evaluation respectively,and CPH⁃I of each patient was calculated. Using pathological results as the gold standard,the optimal cutoff
                value for each diagnostic method was obtained by Youden index. The diagnostic efficacy of the two ultrasound models alone and in
                combination with CPH⁃I was compared. The diagnostic efficacy of O⁃RADS 4 masses and IOTA uncertain masses combined with CPH⁃I
                was calculated,too. Delong test was used to compare the area under the curve(AUC)of receiver operating characteristic curve for each
                model. Results:The optimal cutoff value for O⁃RADS diagnosis was O⁃RADS 4 tumors,the optimal cutoff value for IOTA simple rule

               [基金项目] 国家自然科学基金(82371979);南京市博士后基金(2024BHS201);滁州市卫生健康科研项目(CZWJ2024C007)
                通信作者(Corresponding author),E⁃mail:helenhuyu@njmu.edu.cn(ORCID:0000⁃0002⁃8692⁃0902)
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