Analysis of risk factors and prediction method of ovarian torsion with ischemic necrosis in children with ovarian tumors
10.3760/cma.j.cn115355-20230519-00258
- VernacularTitle:儿童卵巢肿瘤合并卵巢扭转缺血坏死的危险因素及预测方法分析
- Author:
Feng WANG
1
;
Hongwei XI
Author Information
1. 山西省儿童医院普通外科，太原 030013
- Keywords:
Ovarian neoplasms;
Child;
Ovarian torsion;
Ischemia;
Necrosis
- From:
Cancer Research and Clinic
2023;35(10):765-769
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors for ovarian torsion with ischemic necrosis in children with ovarian tumors and create a comprehensive prediction scoring system.Methods:A retrospective analysis was conducted on the clinical data of 72 children with ovarian tumors who underwent surgery in Shanxi Children's Hospital from October 2012 to October 2022. Among them, 38 cases were confirmed to have ovarian torsion during surgery, and they were divided into the necrosis group (27 cases) and the non-necrosis group (11 cases) based on whether the twisted ovary had ischemic necrosis. The clinical characteristics, preoperative inflammatory index levels, tumor marker levels, tumor condition and torsion were compared between the two groups. The factors with statistically significant differences between the two groups based on univariate analysis were used to create a comprehensive prediction scoring system, the prediction efficacy of the scoring system for ischemic necrosis of ovary was evaluated by drawing the receiver operating characteristic (ROC) curve with the intraoperative reality as gold standard, and the sensitivity and specificity were calculated.Results:The best cut-off value for the maximum tumor diameter obtained based on the ROC curve was 8.5 cm. There were no significant differences in age, menarche, onset time, clinical symptoms, levels of tumor markers, torsion direction, torsion side, and nature of the tumor between the necrosis group and the non-necrosis group (all P > 0.05). The duration of pain exacerbation > 48 hours, the maximum tumor diameter < 8.5 cm, the elevated leukocyte count >10×10 9/L, the percentage of neutrophils > 70%, and the degree of torsion ≥ 2 cycles were related factors of ischemic necrosis in ovarian torsion (all P < 0.05). A comprehensive prediction scoring system was created by integrating the above five risk factors. ROC cure analysis showed that the area under the curve was 0.956, the best cut-off value was 3.5 points, and the sensitivity and specificity of prediction were 93% and 82%, respectively. Conclusions:The comprehensive prediction scoring system based on risk factors for ischemic necrosis of the ovary in children with ovarian tumors combined with ovarian torsion has high sensitivity and specificity in predicting the occurrence of ischemic necrosis of the ovary and helps to reduce the rate of ovarian resection.
