Page 28 - 南京医科大学自然版

第46卷第8期
·1134 · 南 京 医 科 大 学 学 报 2026年8月

肿块和 CPH⁃I 联合诊断比 O⁃RADS 分类单独诊断 简单法则单独诊断附件肿块的 AUC 更高，但差异
附件肿块的 AUC 更高（Z=2.285，P=0.022）。IOTA 无统计学意义（Z=0.580，P=0.562）。典型病例见
简单法则不确定性肿块和 CPH⁃I 联合诊断比 IOTA 图 2、3。

表2 O⁃RADS分类、IOTA简单法则及CPH⁃I分别及联合诊断附件肿块的效能比较
Table 2 Comparison of the efficacy of O⁃RADS，IOTA simple rules，and CPH⁃I in individual and combined diagnosis of
adnexal masses
Sensitivity Specificity Accuracy Positive Negative
Methods AUC
（%） （%） （%） predictive value predictive value
O⁃RADS 0.866 096.8 76.4 79.9 0.462 0.991
IOTA simple rules 0.926 100.0 85.1 87.7 0.585 1.000
CPH⁃I 0.886 083.9 93.2 91.6 0.722 0.965
O⁃RADS+CPH⁃I 0.861 100.0 72.3 77.1 0.431 1.000
IOTA simple rules+CPH⁃I 0.902 100.0 80.4 83.8 0.517 1.000
O⁃RADS 4 masses+CPH⁃I 0.933 096.8 89.9 91.1 0.667 0.993
IOTA uncertain masses+CPH⁃I 0.941 093.5 94.6 94.4 0.784 0.986

A B

38⁃year⁃old female，CA125：205.6 U/mL，HE4：46.9 pmol/L，CPH⁃I：-2.489（<-2.165）. A：Ultrasound image shows a cystic⁃solid mass of
6.6 cm×5.0 cm in the left adnexa area with irregular shape，classified as O⁃RADS 5 and IOTA benign mass. When using O⁃RADS 4 masses combined
with CPH⁃I diagnosis，it is considered malignant. While when IOTA uncertainty masses combined with CPH⁃I diagnosis is used as the standard，it is
considered benign. B：Pathological image shows it is fallopian tube and ovarian abscess（HE×100）.
图2 左侧输卵管卵巢脓肿患者图像
Figure 2 Images of a patient with left fallopian tube and ovarian abscess

A B
50⁃year⁃old female，CA125：455.9 U/mL，HE4：578.7 pmol/L，CPH⁃I：2.387（>-2.165）. A：Ultrasound image shows a solid mass of 12.6 cm×8.8 cm
in the right adnexa area with irregular shape，classified as O⁃RADS 5 and IOTA malignant mass. When the two ultrasound models combined the with
CPH⁃I diagnosis，they were both considered malignant. B：Pathological image shows it is high⁃grade serous carcinoma of the ovary（HE×100）.
图3 右侧卵巢高级别浆液性癌患者图像
Figure 3 Images of a patient with high⁃grade serous carcinoma of right ovary