卵巢良恶性肿瘤的超声征象及其与卵巢癌临床分期、病理分级的相关性分析

摘要 目的：探讨卵巢肿瘤良恶性病变的超声征象及其与卵巢癌临床分期、病理分级的相关性。方法：选取我院2020年8月到2023年8月收治的148例卵巢肿瘤患者进行回顾性分析，以手术病理及病理活检作为诊断金标准，将60例确诊为卵巢癌的患者纳入恶性组，将88例确诊为卵巢良性肿瘤的患者纳入良性组。对所有患者进行超声检查，分析其超声图像特征。随后分析60例卵巢癌患者不同临床分期和病理分级患者的超声诊断参数情况，并分析超声诊断相关参数与卵巢临床分期、病理分级的相关性。结果：超声对卵巢肿瘤良性诊断准确率为86.36 %（76/88）对恶性肿瘤诊断率为88.64 %（78/88）；不同临床分期患者RI、PI、EDV、PSV对比差异显著，Ⅰ期患者RI、PI为（0.77±0.14）和（1.67±0.24）高于Ⅱ期（0.64±0.15）和（1.25±0.16）、Ⅲ期患者（0.52±0.17）和（0.96±0.16）、Ⅳ期（0.41±0.12）和（0.76±0.12），Ⅰ期患者EDV和PSV（8.63±1.27）cm/s和（16.53±2.53）cm/s低于Ⅱ期（10.25±1.68）cm/s和（18.44±1.58）cm/s、Ⅲ期（12.73±1.79）cm/s和（20.14±2.25）cm/s、Ⅳ期患者（15.51±1.12）cm/s和（23.06±1.98）cm/s（P＜0.05）；不同临床分期患者RI、PI、EDV、PSV对比差异显著，Ⅰ级患者RI、PI为（0.81±0.16）和（1.62±0.19）高于Ⅱ级（0.65±0.12）和（0.91±0.22）、Ⅲ级患者（0.47±0.17）和（0.67±0.13），Ⅰ级患者EDV和PSV（8.32±1.51）cm/s和（15.12±3.33）cm/s低于Ⅱ级（12.75.±1.14）cm/s和（21.31±3.14）cm/s、Ⅲ级患者（15.35±1.79）cm/s和（24.08±2.04）cm/s（P＜0.05）；Spearman相关分析结果表明：临床分期、病理分级与RI、PI呈负相关，与EDV、PSV呈正相关（P＜0.05）。结论：超声对卵巢肿瘤的良恶性病变诊断具有重要指导价值，且与卵巢癌的临床分期、病理分级具有明显相关性，值得临床应用推广。

Analysis of Ultrasound Signs of Benign and Malignant Tumors of the Ovary and Their Correlation with Clinical Stage and Pathological Grading of Ovarian Cancer

ABSTRACT Objective: To investigate the ultrasound signs of benign and malignant lesions of ovarian tumors and their correlation with clinical staging and pathological grading of ovarian cancer. Methods: 148 patients with ovarian tumors admitted to our hospital from August 2020 to August 2023 were selected for retrospective analysis, and surgical pathology and pathological biopsy were used as the gold standard for diagnosis, 60 patients diagnosed with ovarian cancer were included in the malignant group, and 88 patients diagnosed with benign ovarian tumors were included in the benign group. Ultrasonography was performed on all patients and their ultrasound image characteristics were analyzed. Subsequently, the ultrasound diagnostic parameters of 60 patients with ovarian cancer in different clinical stages and pathological grades were analyzed, and the correlation between ultrasound diagnostic related parameters and ovarian clinical stages and pathological grades was analyzed. Results: The accuracy of ultrasound in the diagnosis of benign ovarian tumors was 86.36% (76/88), while the diagnostic rate of malignant tumors was 88.64% (78/88); There were significant differences in the comparison of RI, PI, EDV, and PSV among patients with different clinical stages. The RI and PI of stage I patients were (0.77±0.14) and (1.67±0.24) higher than those of stage II patients (0.64±0.15) and (1.25±0.16), stage III patients (0.52±0.17) and (0.96±0.16), stage IV patients (0.41±0.12) and (0.76±0.12). The EDV and PSV of stage I patients were (8.63±1.27) cm/s and (16.53±2.53) cm/s lower than those of stage II patients (10.25±1.68) cm/s and (18.44±1.58) cm/s Phase III patients (12.73±1.79) cm/s and (20.14±2.25) cm/s, and Phase IV patients (15.51±1.12) cm/s and (23.06±1.98) cm/s (P<0.05); There were significant differences in the comparison of RI, PI, EDV, and PSV among patients with different clinical stages. The RI and PI of grade I patients were (0.81±0.16) and (1.62±0.19) higher than those of grade II patients (0.65±0.12) and (0.91±0.22), grade III patients (0.47±0.17) and (0.67±0.13). The EDV and PSV of grade I patients were (8.32±1.51) cm/s and (15.12±3.33) cm/s lower than those of grade II patients (12.75±1.14) cm/s and (21.31±3.14) cm/s Grade III patients (15.35±1.79) cm/s and (24.08±2.04) cm/s, (P<0.05); The Spearman correlation analysis results showed that clinical staging and pathological grading were negatively correlated with RI and PI, but positively correlated with EDV and PSV (P<0.05). Conclusion: Ultrasound has important guiding value in the diagnosis of benign and malignant ovarian tumors, and has a significant correlation with the clinical staging and pathological grading of ovarian cancer, which is worthy of clinical application and promotion.