Epithelial Ovarian Cancer Standardized Clinical Early Diagnosis Of Recurrence After Treatment Of Evidence-based Medical Research

Objective:To discuss the diagnosis value of serum CA125testing on epithelialovarian malignant tumor recurrence after treatment and the influence of the curativeeffect, in order to guide clinical diagnosis and treatment. Methods:Radioimmunoassay was used to continuous monitoring the serum CA125of152cases of epithelial ovarian cancer patients. Tested once before surgery, every monthdetermination once, two consecutive years of above. Results:152cases of patientswith epithelial ovarian cancer remission, some patients relapse. For the critical valueof serum CA125to35u/ml, the diagnosis of recurrent sensitivity of67.39%and aspecificity of86.79%.Serum CA125before treatment, serum CA125decreased theextent and speed after treatment related to the prognosis of patients, serum CA125before treatment no more than35u/ml have a good prognosis compare with serumCA125before treatment exceed35u/ml, serum CA125after treatment with alogarithmic decline or within a month fell to normal have a good prognosis comparewith serum CA125after treatment is not a logarithmic decline or greater than1months fell to normal; Serum CA125rising content when recurrence and clinicalappear lesions time have particular concern, CA125rise higher content, appear in theshorter the time, its relevance is negatively related to; Multivariate Cox regressionmodel analysis showed that, Serum CA125before treatment and the speed of decline of serum CA125after treatment are an independent prognostic factors. Conclusion：The level of serum CA125testing on epithelial oarian cancer recurrence diagnosis,curative effect evaluation to have the important meaning. Objective:To evaluate the diagnostic value of serum CA125levels on epithelialovarian cancer recurrence after treatment. Methods:We search Medline, EMbase,PubMed, Cochrane Library, EBMR, CBM, CJFD, CSJD, tsinghua tongfang database,etc. from January1,1995to December31,2011. Articles related to the diagnosticvalue of serum CA125on epithelial ovarian cancer recurrence were selected. weevaluate documents quality base on the diagnostic test accuracy quality evaluationtools (QUADAS) and the studies meet the requirements were extracted, data analysiswas conducted by Meta-Disc1.4software. Results:Ten studies with a total of617epithelial ovarian cancer cases (patients) were included. The results of meta-analysisshowed that the diagnostic odds ratio of serum CA125level on epithelial ovariancancer recurrence after treatment was10.38(95%Cl=6.08～17.72), sensitivity andspecificity were62%(95%Cl=57%～67%) and86%(95%Cl=80%～91%), positivelikelihood ratio and negative likelihood ratio were3.99(95%Cl=2.17～7.31) and0.45(95%Cl=0.39～0.52). Conclusion:Serum CA125have general sensitivity andhigher specificity on diagnosis epithelial ovarian cancer recurrence after treatment, itcan be used as an effective tool for diagnosis of recurrent epithelial ovarian cancer. Objective:To discuss the diagnostic value of imaging studies (B ultrasound, CT) onepithelial ovarian cancer recurrence after treatment. Methods:152cases of ovariancancer patients with postoperative were checked by B ultrasound, CT scan and serumCA125levels, the test results were compared with the pathological results,calculatedthe diagnostic sensitivity and specificity of individual check and joint model. UsingSAS8.0software package using the Logistic regression method to72cases wererandomly selected to build the regression model,80cases used to validate the modeland ultra-alone B, CT results were compared. Results:The B ultrasound alone,sensitivity and specificity were84.78%and89.62%, the CT scan alone, the sensitivityand specificity were86.96%and91.51%, a separate to CA125check, sensitivity andspecificity were67.39%and86.79%, B ultrasound and CA125model sensitivity andspecificity were84.62%and85.69%, the sensitivity and specificity of CT and CA125model is92.31%and94.44%respectively. Conclusion:CT and CA125model has abetter diagnostic performance to recurrent ovarian cancer. The sensitivity andspecificity are higher, It is an effective method of monitoring epithelial ovarian cancerrecurrence. Objective:To evaluation the diagnostic value imaging examination (B ultrasound, CTand MRI, PET/CT) on epithelial ovarian cancer recurrence after treatment.Methods:We search Medline, EMbase, PubMed, Cochrane Library, EBMR, CBM,CJFD, CSJD, tsinghua tongfang database, etc. from January1,1995to December31,2011. Articles related to the diagnostic value of imaging examination (B ultrasound,CT and MRI, PET/CT) on epithelial ovarian cancer recurrence were selected. weevaluate documents quality base on the diagnostic test accuracy quality evaluationtools (QUADAS) and the studies meet the requirements were extracted, data analysiswas conducted by Meta-Disc1.4software. Results:Eight studies with a total of478epithelial ovarian cancer cases (patients) about CT and three studies with a total of184epithelial ovarian cancer cases (patients) abou MRI and ten studies with a total of559epithelial ovarian cancer cases (patients) about PET/CT were included. Theresults of meta-analysis showed that the diagnostic odds ratio of CT on epithelialovarian cancer recurrence after treatment was10.32(95%Cl=4.93～21.62),sensitivity and specificity were70%(95%Cl=64%～75%) and81%(95%Cl=75%～86%), positive likelihood ratio and negative likelihood ratio were3.11(95%Cl=2.30～4.19) and0.35(95%Cl=0.23～0.55). The diagnostic odds ratio of MRI onepithelial ovarian cancer recurrence after treatment was48.17(95%Cl=15.02～154.51), sensitivity and specificity were85%(95%Cl=78%～91%) and90%(95%Cl =77%～97%), positive likelihood ratio and negative likelihood ratio were7.83(95%Cl=3.09～19.87) and0.19(95%Cl=0.07～0.52). The diagnostic odds ratio ofPET/CT on epithelial ovarian cancer recurrence after treatment was71.48(95%Cl=29.31～174.34), sensitivity and specificity were88%(95%Cl=85%～92%) and90%(95%Cl=85%～94%), positive likelihood ratio and negative likelihood ratiowere6.57(95%Cl=4.44～9.72) and0.12(95%Cl=0.06～0.23). Conclusion:CT,MRI, PET/CT have the higher sensitivity and specificity on diagnosis epithelialovarian cancer recurrence after treatment.