余晶莹,祁 璘

女性附件肿块是妇科临床常见病变，其良恶性鉴别直接关乎治疗方案制定与患者预后。卵巢恶性肿瘤风险预测模型基于人附睾蛋白4和糖类抗原125，结合患者年龄因素构建，为附件肿块术前风险评估提供了客观量化指标。本文系统梳理ROMA指数的构建原理、临床应用现状，重点分析其在不同人群、不同病理类型附件肿块中的诊断准确性，对比其与单一肿瘤标志物、影像学检查及其他联合诊断方案的效能差异，探讨当前研究存在的局限性，并对未来研究方向及临床应用前景进行展望，为临床优化附件肿块术前风险评估策略提供参考。

ROMA指数；附件肿块；术前风险评估；诊断准确性；肿瘤标志物；综述

[1] Liao H,Yang F,Guo T,et al.Transumbilical laparoendoscopic single-site surgery(TU-LESS)for gynecological diseases during pregnancy:a retrospective study from a single center[J].BMC Pregnancy and Childbirth,2025,25(1):1024-1024. [2] Arena A,Doglioli M,Fuso L,et al.Application of a denoising doppler algorithm in adnexal masses ultrasound:impact on color score attribution and perceived image quality.[J].Ultraschall in der Medizin(Stuttgart,Germany:1980),2025, [3] T.O F,S.D C,Alexia I,et al.A Feasibility Study for Mapping Ovarian Sentinel Lymph Nodes:A Memorial Sloan Kettering Cancer Center Team Ovary Study[J].Obstetrics&Gynecology,2025, [4] 苏漫婷,吴曼丽,张曼,等.超声造影提高O-RADS 4~5类附件肿块诊断准确性的多中心回顾性研究[J].新医学,2025,56(09):872-881. [5] FlídrováM,KrkavcováE,HájkováN,et al.Synchronous mucinous metaplasia and neoplasia of the ovarium and fallopian tube with STK11 and KRAS mutations:a case report.[J].Virchows Archiv:an international journal of pathology,2025,(prepublish):1-6. [6] Nandhana V,Rajeswari R S K,Sadhana K.A Comparative Study Between the Diagnostic Accuracy of IOTA Simple Rules and Risk Malignanct Index(RMI)in Differentiating Malignant from Benign Adnexal Masses[J].The Journal of Obstetrics and Gynecology of India,2025,(prepublish):1-7. [7] Bahadur A,Singhvi S,Mundhra R,et al.Evaluation of the Performance of the IOTA ADNEX Model in Discriminating Adnexal Masses Preoperatively:An Ambispective Study.[J].Journal of obstetrics and gynaecology Canada:JOGC=Journal d'obstetrique et gynecologie du Canada:JOGC,2025,103071. [8] O'Dell N C,McCadams S J.Extrauterine Leiomyoma of the Sigmoid Colon Mimicking an Adnexal Mass[J].Cureus,2025,17(8):e89842-e89842. [9] Metwally E D,Essawy E S S,Gaballah M K,et al.Diagnostic performance of O-RADS MRI score in evaluation of adnexal masses based on enhanced non-DCE-MRI[J].Egyptian Journal of Radiology and Nuclear Medicine,2025,56(1):125-125. [10] Guo M,Zeng T S,Wu N X,et al.Ovarian hemangioma:A rare case report.[J].The Journal of international medical research,2025, 53(8):3000605251366972. [11] Yang Y,Wang H,Su N,et al.O-RADS US versus IOTA simple rules in the diagnosis of benign and malignant adnexal masses:a prospective study[J].BMC Medical Imaging,2025,25(1):297-297. [12] Abuelhassan A.Ovarian Torsion in Patients With Polycystic Ovary Syndrome Without Ovulation Induction or an Adnexal Mass:A Report of Two Cases[J].Cureus,2025,17(7):e88608-e88608. [13] 关三丽,乔敏霞,李娜,等.O-RADS US联合多种血清学参数对附件肿块定性价值分析[J].中国超声医学杂志,2025,41(07):796-800. [14] Y.E.Almalki,M.A.A.Basha,M.G.Nada,等.卵巢-附件影像报告与数据系统(O-RADS)超声2019版:在病理确诊的附件肿块中进行前瞻性验证并与更新版(v2022)进行比较[J].国际医学放射学杂志,2025,48(04):492. [15] Arnold L G,Salvador C T,Marely N T I,et al.Intraperitoneal metastases from cutaneous melanoma in a 2-year-old girl:A case report[J].Journal of Pediatric Surgery Case Reports,2025,120 103049-103049. [16] Moro F,Momi M,Ledger A,et al.External validation of ultrasound-based models for differentiating between benign and malignant adnexal masses:a nationwide prospective multicenter study(IOTA phase 6).[J].American journal of obstetrics and gynecology,2025, [17] Areys M H,Abdi S M,Omer H N,et al.Ruptured heterotopic pregnancy with successful term intrauterine pregnancy outcome after natural conception:a case report[J].Journal of Medical Case Reports,2025,19(1):329-329. [18] Erdoğan C,TopalÜ,Çelik E,et al.Evaluation of adnexal masses with ultrasonographic parameters and magnetic resonance imaging.[J].Archives of gynecology and obstetrics,2025,(prepublish):1-9. [19] 张晓琴,林斯宏,林泽林,等.基于O-RADS MRI评分的临床与多参数MRI预测模型在子宫附件良恶性肿块鉴别中的应用价值[J].磁共振成像,2025,16(07):39-46. [20] Saleem M M,Pervaiz M,Mazhar I,et al.Ovarian Torsion Secondary to a Dermoid Cyst in a Child:A Case Report[J].Cureus,2025, 17(6):e86565-e86565. [21] 马璐阳,赵玉娇,张程,等.DWI对卵巢-附件影像报告和数据系统(O-RADS)MRI评分的附加价值[J].中国临床医学影像杂志,2025,36(06):437-441. [22] Alnaggar M,Mahyoub A M,Alshargabi N,et al.Struma ovarii—diagnostic and treatment strategy:a case report[J].Journal of Medical Case Reports,2025,19(1):285-285. [23] Siferih M,Negasa T,Yifru M,et al.Suspected Ovotesticular Disorders of Sexual Differentiation in a Phenotypic Male With Ambiguous Genitalia,Light Menstrual Flow,and Synchronous Bilateral Dysgerminoma:A Case Report From Ethiopia[J].Case Reports in Pediatrics, 2025,2025(1):7659991-7659991. [24] Manisha M,Chennaboina D,Sharma C,et al.Urinoma masquerading as an adnexal mass in pregnancy:An unusual sequela of spontaneous calyceal rupture[J].European Journal of Obstetrics&Gynecology and Reproductive Biology,2025,311 114077-114077. [25] Subedi N,Joshi N.Giant omental lipoma arising from broad ligament mimicking as adnexal mass:a diagnostic dilemma.[J].Journal of surgical case reports,2025,2025(6):rjaf450. [26] 林小鸳,冯家明,潘洁菲,等.超声O-RADS分类与MSCT检查在诊断卵巢-附件区肿块中的应用比较[J].影像技术,2025,37(03):67-73. [27] 刘彤.卵巢-附件超声报告和数据系统联合超声图像特征对卵巢附件良恶性肿块的鉴别诊断价值探述[C]//重庆市健康促进与健康教育学会全科专委会.2025精神医学与心理健康系列研讨会论文集(一).赤峰市第二医院;,2025:462-465. [28] 赵薇,盛桂梅,刘婕,等.IOTA简单法则与O-RADS诊断附件肿块良恶性的对比研究[J].临床超声医学杂志,2025,27(04):321-326. [29] 伍丽娟,苏巧媛,罗慧.超声O-RADS在不同级别医师间诊断效能及一致性比较[J].医学影像学杂志,2025,35(04):106-109+116. [30] 车慧娟.超声诊断附件区囊性肿块的价值分析[J].中国城乡企业卫生,2025,40(05):161-163. [31] 黄金慧,孙美玉.卵巢附件影像报告和数据系统MRI风险分层的研究现状及应用挑战[J].放射学实践,2025,40(03):415-420.

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