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目的 分析各预测因素对卵巢肿瘤良恶性鉴别的价值,探讨改良恶性风险指数(modified risk of malignancy index,mRMI)鉴别卵巢肿瘤良恶性的效果.方法 回顾性分析2010年1月至2017年1月北京大学第一医院妇产科首诊并手术治疗的1792例卵巢肿瘤患者的临床资料,统计多项临床指标在良恶性间的分布情况,根据ROC曲线(受试者工作特征曲线,receiver operating characteristic curve)分析四种恶性风险指数(risk of malignancy index,RMI)及各种改良方法的预测效果.结果 四种RMI预测的敏感性为57.2％～ 62.8％,特异性为89.0％～91.9％,其中RMI 4的预测效果优于RMI 1、2、3;在四种RMI中加入新因素血流阻力指数(resistance index,RI)后,预测效果均得到显著改善,其中RMI 4改良后的效果最好,其敏感性和特异性分别达到77.0％和79.0％.结论 RMI对卵巢肿瘤良恶性的预测有较高价值;加入RI改良RMI后预测效果有显著提高,推荐改良恶性风险指数=(超声评分+血流评分)×绝经状态评分×CA125(carbohydrate antigen 125,糖类抗原125)×肿瘤长径评分[mRMI=(U+R)×M×CA125×S],以190为界值,大于界值者考虑为恶性.“,”Objective To analyze the values of several factors in differential diagnosis of ovarian tumors and to evaluate the diagnostic values of modified risk of malignancy index (mRMI) for ovarian tumors.Methods The data of 1792 women with ovarian tumors admitted to Peking University First Hospital for surgical exploration between January 2010 and January 2017 were retrospectively analyzed.The differences of several clinical indicators between benign and malignant ovarian tumors were calculated.The diagnostic values of the 4 RMIs and various modified methods were analyzed according to ROC curves (receiver operating characteristic curve).Results The sensitivities of 4 RMIs for diagnosing malignant tumors ranged from 57.2％ to 62.8％,specificities ranged from 89.0％ to 91.9％.RMI4 was significantly better than RMI1,2,3 in terms of diagnostic efficiency.The diagnostic efficiency of 4 RMIs could be improved when RI (resistance index) was added to the formulas,and modified RMI4 had the best diagnostic efficiency with a sensitivity of 77.0％ and a specificity of 79.0％.Conclusions RMIs are useful indexes for the differentiation between benign and malignant ovarian tumors.RI could significantly improve the diagnostic efficiency.The advised mRMI equals to (ultrasound score + RI score) × menopausal score × CA125 (carbohydrate antigen 125) × tumor size score [mRMI=(U+R) × M × CA125 × S],with a cutofflevel of 190.