| [Objective]We summarize ultrasound characters of the ovarian tumors and survey the level of tumor markers such as CA125,CA199,and then come up with an evaluation system composed of factors related to ultrasound and flow indexes and also refer to pathological results. Results explored the value of ultrasound combined with tumor markers in differential diagnosis between the benign and malignant ovarian tumors.Differential diagnosis of the characters of ovarian neoplasms directly relate to therapeutic regimen and prognosis.[Methods]We collected 80 patients including 100 tumors,who were diagnosed or under suspicion of ovarian tumors from April in 2006 to November in 2008.The cases were confirmed benign,malignant ovarian tumors or other nature tumors by pathology after surgery.A transvaginal ultrasonic examination or an ultrasonic examination via abdomen was conducted for each patient to demonstrate the structures of the womb and the tumors in the two-dimensional ultrasound were recorded before surgery.After we observed the tumors' characters carefully, color Doppler ultrasonic examinations were conducted with parameters of the flow indexes recorded.The resistance index(RI)≤0.43,the pulsatility index(PI)≤1.0 were the diagnosis reference of the malignant ovarian tumors.We also measured the concentrations of CA125,CA199 before surgery.CA125≥65KU/L and CA199≥37U/ml were the diagnosis criteria of the malignant ovarian tumors.Referring to the pathology results,we analyzed the statistics analysis and drew the conclusion.[Results]1.The sensitivity of using the ultrasonography in judging the malignancy of tumors is 89.29%,the specificity,83.33%,the accuracy,86.73%,the positive predictive value,87.72%, the negative predictive value,85.37%,the positive likelihood ratio,5.36 and the negative likelihood ratio,0.13.2.With the criteria through which a tumor is judged as malignant if CA125≥65KU/L and/or CA199≥37U/ml,the sensitivity is 81.03%,the specificity,78.23%,the accuracy, 85.16%,the positive predictive value,83.92%,the negative predictive value,85.91%,the positive likelihood ratio,2.12 and the negative likelihood ratio,0.22.3.In regard to the diagnosis of benignancy and malignancy of ovarian tumors,based on the combination ultrasonography and tumor markers including CA125 and CA199,the sensitivity is 92.83%,the specificity,94.47%,the accuracy,94.35%,the positive predictive value,94.56%, the negative predictive value,94.17%,the positive likelihood ratio,4.57 and the negative likelihood ratio,0.05.4.The malignant ovarian tumors showed the typical characters with the two-dimensional ultrasound:the shape is irregular,the outline is fuzzy,echo edge is not sharp,with disrupted capsular or without capsule,the uneven thickness,various internal echo,the diffuse punctuate distribution of the clutter of mass integration of echo,or uneven fluid inside the irregulal anechoic area,some associated with ascites.Malignant tumor with the capsule-based,mixed mass is very commom in malignant tumor,followed by solid tumors without homogeneous echo.5.In the CDFI,the malignant ovarian tumors showed a rich,a large number of strips, semi-annular flow,diffusion and distribution blood flow signals within the tumor center or papillary processes on the interval.RI≤0.43 and PI≤1.0 of the flow indexes are associated with the malignancy of ovarian tumors.[Conclusion]The examination include the two-dimensional ultrasound and the color Doppler flow image,combined with the tumor markers of CA125,CA199 can make up the lackness of a separate one.The combined diagnostic method is a good way to differentiate the benign from the malignant ovarian tumors.It can help to reduce the false-negative and the miss diagnose,improving the accuracy of diagnosis of the malignancy of ovarian tumors.It also can provide the basis for the clinical treatment programs. |
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