Useful preoperative examination findings to classify the grade of ovarian primary mucinous tumor
Useful preoperative examination findings to classify the grade of ovarian primary mucinous tumor
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DOI：
10.1007/s00261-020-02918-4
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发表时间：
2021-01-02
影响因子：
2.4
通讯作者：
Fujinaga, Yasunari
中科院分区：
文献类型：
--
作者：
Ohya, Ayumi;Ichinohe, Fumihito;Fujinaga, Yasunari
目的探讨卵巢原发性粘液性肿瘤（OPMTs）的MRI表现及肿瘤标志物的变化，并探讨其在判断良性、交界性、恶性等不同级别OPMTs中的价值。方法回顾性分析95例经手术病理证实的卵巢良性肿瘤53例，交界性恶性肿瘤24例，恶性肿瘤18例。卵巢肿块的MRI特征，即最大直径、蜂窝腔、实性成分（SC）、染色玻璃图案和囊肿在T1（T1 WI）和T2加权成像（T2 WI）上的信号强度，有/无脂肪抑制，以及术前STM，即癌胚抗原（CEA）、碳水化合物抗原（CA）19-9和CA 125，采用单因素分析比较三种肿瘤分级之间的差异。我们还分析了研究结果，估计病理诊断使用分类树（CT）分析。结果肿瘤最大直径、蜂窝状腔、SC、染色玻璃样改变、囊肿信号[T1、T2 WI均高信号（T1-hyper/T2-hyper），T1 WI高信号、T2 WI低信号（T1-hyper/T2-hypo）]、CEA、CA 19-9浓度在3种肿瘤分级间差异有统计学意义（p < 0.05）。以CT T1-hyper/T2-hypo、CEA、CA 19-9诊断与病理诊断符合率最高，以CT T1-hyper/T2-hypo、CEA、SC诊断与病理诊断符合率最高。T1-hyper/T2-hypo和CEA均阴性的病变提示良性; T1-hyper/T2-hypo阳性和CA 19-9或SC阴性的病变提示BM; T1-hyper/T2-hypo阴性和CEA阳性的病变，或T1-hyper/T2-hypo和CA 19-9或SC均阳性的病变提示恶性。
Purpose To evaluate various imaging features on magnetic resonance imaging (MRI) and tumor markers and their utility to assess various grades of ovarian primary mucinous tumors (OPMTs): benign, borderline, or malignant. Methods Ninety-five pathologically diagnosed OPMTs [53 benign, 24 borderline malignant (BM), and 18 malignant] were selected in this retrospective study. MRI features of the ovarian mass, namely the maximum diameter, honeycomb loculi, solid components (SC), stained-glass pattern, and signal intensity of the cyst on T1- (T1WI) and T2-weighted imaging (T2WI) with/without fat suppression, and preoperative STMs, namely carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and CA125, were compared between the three tumor grades using univariate analysis. We also analyzed the findings to estimate the pathological diagnosis using classification tree (CT) analysis. Results Maximum diameter, honeycomb loculi, SC, stained-glass pattern, signal intensity of the cyst [hyperintensity on both T1WI and T2WI (T1-hyper/T2-hyper), and hyperintense on T1WI and hypointense on T2WI (T1-hyper/T2-hypo)], and CEA and CA 19-9 concentrations were significantly different between the three tumor grades (p < 0.05). The concordance rate with the pathological diagnosis was the highest with diagnosis by the CT comprising T1-hyper/T2-hypo, CEA, and CA 19-9 and by the CT comprising T1-hyper/T2-hypo, CEA, and SC. Conclusion Four types of findings were important for OPMT grading. Lesions negative for both T1-hyper/T2-hypo and CEA suggest benign; lesions positive for T1-hyper/T2-hypo and negative for CA 19-9 or SC suggest BM; and lesions negative for T1-hyper/T2-hypo and positive for CEA, or positive for both T1-hyper/T2-hypo and CA 19-9 or SC suggest malignancy.