The Value Of MRI Combined With Serum Tumor Markers In Preoperative Differential Diagnosis Of Mucinous Ovarian Tumors

Objective: To evaluate the value of MRI,serum tumor markers CA-125,HE4,CA19-9 and CEA in the preoperative differential diagnosis of mucinous ovarian tumor.Methods: The clinical features,MRI features and serum tumor markers in 87 patients with MOT who underwent surgery in our hospital from November 2016 to December 2019 were analyzed retrospectively,according to the pathological findings,the patients were divided into benign group(including 54 cases)and non-benign group(including 33cases).And the value of MRI and serological tumor markers in the preoperative differential diagnosis of benign and malignant MOT was analyzed.Results:(1)There was no significant difference in age and menopausal state between the two groups(P>0.05).Among the symptomatic patients,the majority of the patients(73.9% of patients with benign tumors and95.7% of patients with non-benign tumors)had abdominal pain/ abdominal distension/abdominal mass/abdominal girth enlargement.(2)The MRIfeatures of the two groups were compared: there was no difference in tumor diameter(P>0.05),the number of tumor cells in non-benign group was more than that in benign group(P<0.05),the tumor cells in benign group were mainly hypointense on T1 WI and hyperintense on T2 WI,the signal types in non-benign tumors were complex and atypical,and there was significant difference in the proportion of T1 and T2 weighted signal types between the two groups(P<0.05);the majority of benign tumors had no local wall(or septa)thickening,only 3.7% had local wall(or septa)thickening≥5 mm,and more than half(54.5%)of non-benign tumors had local wall(or septa)thickening≥5 mm,the percentage of thickened cystic wall(or septa)was different between the two groups(p < 0.05);and there were significant differences in the ratio of tumor wall nodules(or papillary processes)between the two groups(p<0.05).(3)The serum levels of CA-125,HE4 and CA19-9 in the non-benign group were higher than those in the benign group(P<0.05).The levels of CEA in the benign group and the non-benign group were similar,there was no significant difference between the two groups(P > 0.05).(4)When serum CA-125,HE4 and CA19-9 were used in combination with MRI,the accuracy,sensitivity and negative predictive value of MOT diagnosis were significantly higher than when using one of the detection methods alone(P <0.05),but the specificity was relatively decreased(P<0.05).Conclusions: In the MRI features of mucinous ovarian tumors,thenumber of tumor cells,the signal of cyst fluid,the thickness of cyst wall(or septa),the wall tubercle(or papillary protuberance)are helpful to differentiate benign from non-benign tumors,the above indexes should be paid more attention when using MRI to differentiate benign and malignant MOT preoperatively.Among the four serological tumor markers(CA-125,HE4,CA19-9,CEA)included in our study,CA-125,HE4,CA19-9 are helpful for the differential diagnosis of benign and malignant MOT;and the combined use of CA-125,HE4,CA19-9 and MRI can improve the preoperative diagnostic efficacy of MOT.