Effectiveness of a Multivariate Index Assay in the Preoperative Assessment of Ovarian Tumors
Effectiveness of a Multivariate Index Assay in the Preoperative Assessment of Ovarian Tumors
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DOI：
10.1097/aog.0b013e31821b5118
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发表时间：
2011-06-01
影响因子：
7.2
通讯作者：
Zhang, Zhen
中科院分区：
文献类型：
--
作者：
Ueland, Frederick R.;Desimone, Christopher P.;Zhang, Zhen
目的：比较医师评估与一种新的多变量指标检测在识别高危卵巢肿瘤中的有效性。方法：在一项涉及美国27个初级保健和专科医院的前瞻性多机构试验中，对计划接受卵巢肿瘤手术的女性进行多变量指标分析。术前采集血清，多因素指标测定、医师评估和CA 125结果与手术病理相关。每位医师在手术前记录医师评估。根据美国妇产科医师学会的转诊指南选择ca125截止点。结果：该研究纳入了590名妇女，其中524名可用于多变量指标测定和CA 125, 516名用于医生评估。53%的患者是由非妇科肿瘤学家登记的。卵巢恶性肿瘤161例，良性肿瘤363例。在70%的非妇科肿瘤学家和95%的妇科肿瘤学家中，医师评估加上多变量指标分析正确地识别了医师评估遗漏的恶性肿瘤。多变量指数分析也检测出76%的ca125遗漏的恶性肿瘤。医师评估加上多变量指数测定确定了86%的CA 125遗漏的恶性肿瘤，包括所有晚期癌症。多变量指数测定在早期和晚期癌症中的表现是一致的。结论：与医师评估和CA 125相比，多因素指标法检测卵巢恶性肿瘤的敏感性更高，特异性较低。（journal of gynecology, 2011;117:1289-97） DOI: 10.1097/AOG.0b013e31821b5118
OBJECTIVE: To compare the effectiveness of physician assessment with a new multivariate index assay in identifying high-risk ovarian tumors.METHODS: The multivariate index assay was evaluated in women scheduled for surgery for an ovarian tumor in a prospective, multi-institutional trial involving 27 primary-care and specialty sites throughout the United States. Preoperative serum was collected, and results for the multivariate index assay, physician assessment, and CA 125 were correlated with surgical pathology. Physician assessment was documented by each physician before surgery. CA 125 cutoffs were chosen in accordance with the referral guidelines of the American College of Obstetricians and Gynecologists.RESULTS: The study enrolled 590 women, with 524 evaluable for the multivariate index assay and CA 125, and 516 for physician assessment. Fifty-three percent were enrolled by nongynecologic oncologists. There were 161 malignancies and 363 benign ovarian tumors. Physician assessment plus the multivariate index assay correctly identified malignancies missed by physician assessment in 70% of nongynecologic oncologists, and 95% of gynecologic oncologists. The multivariate index assay also detected 76% of malignancies missed by CA 125. Physician assessment plus the multivariate index assay identified 86% of malignancies missed by CA 125, including all advanced cancers. The performance of the multivariate index assay was consistent in early-and late-stage cancers.CONCLUSION: The multivariate index assay demonstrated higher sensitivity and lower specificity compared with physician assessment and CA 125 in detecting ovarian malignancies. (Obstet Gynecol 2011;117:1289-97) DOI: 10.1097/AOG.0b013e31821b5118