Clinical Value Of Commonly Used Tumor Markers In Differential Diagnosis Of Benign And Malignant Ovarian Tumors

Objective:To evaluate the clinical value of CA125,CA199,HE4 and LDH single and combined detection in benign and malignant ovarian tumors differential diagnosis.Methods:Chemiluminescent microparticle immunoassay and enzyme rate assay were used to detect the serum levels of tumor markers,220 epithelial ovarian cancer patients,78 epithelial ovarian borderline tumor patients,120 ovarian mature teratoma patients and 162 ovarian endometriosis patients were detected in the Affiliated Tumor Hospital of Xinjiang Medical University during January 2013 to December2015.Results:(1)The levels of CA125,CA199,HE4 and LDH in epithelial ovarian cancer group were significantly higher than other three groups(P<0.05).(2)The sensitivity of HE4 in the diagnosis of epithelial ovarian cancer was 73.18%,the specificity was98.89%,the Youden index was 72.07% and the area under the ROC curve was 0.952.HE4 was the best among of four tumor markers when considered all evaluation indexes.(3)The sensitivity of the combined detection of CA125,CA199,HE4 and LDH in the diagnosis of epithelial ovarian cancer was 97.73%,the specificity was 25% and the area under the ROC curve was 0.973.Combined detection of four tumor markers showed the highest diagnostic value.(4)The sensitivity of CA125 and HE4 in the diagnosis of ovarian serous adenocarcinoma and ovarian endometrioid carcinoma was higher.The sensitivity of CA199 in diagnosis of ovarian mucinous adenocarcinoma and ovarian clear cell carcinoma was higher.The sensitivity of LDH in the diagnosis of different pathological types of epithelial ovarian cancer was not high.(5)The sensitivity of CA125,CA199 and HE4 in the diagnosis of early epithelial ovarian cancer was high,but LDH was low.(6)The sensitivity and specificity of CA125 and CA199 in diagnosis of epithelial borderline ovarian tumors and ovarian endometrioma were high,and the sensitivity and specificity of CA199 in the diagnosis of mature cystic teratoma of the ovary was higher than that of CA125.(7)The combined detection of CA125 and CA199 improved the sensitivity in the diagnosis of epithelial borderline ovarian tumors,mature cystic teratoma of the ovary and ovarian endometrioma.Conclusions:(1)The combined detection of CA125,CA199,HE4 and LDH is the ideal combination of tumor markers on epithelial ovarian cancer diagnosis.(2)The combined detection of CA125 and CA199 can improve the diagnostic capability of epithelial borderline ovarian tumors,mature cystic teratoma of the ovary and ovarian endometrioma.