| Background Ovarian malignant tumor is one of the malignant neoplasms with higher incidence in women.It is ignored by patients because this disease is often mild or even asymptomatic in the early stage.Thus,the patients are not diagnosed and treated in time.At present,lacking effective treatments and the high recurrence rate for patients with advanced ovarian malignant tumor result in the first mortality rate of the disease in gynecological malignancies.Therefore,being diagnosed and treated clinically in early stage are important to improve the prognosis of patients.Common tumor markers used for screening ovarian malignant tumors are cancer antigen 125(CA125),human epididymis protein 4(HE4),and carbohydrate antigen 19-9(CA199),Alpha-fetoprotein(AFP),etc.These tumor markers not only exist in ovarian malignant tumors,but also are expressed in other human malignant tumors such as cervical cancer,endometrial carcinoma,and gastrointestinal malignancies.Single tumor markers have low sensitivity or specificity for ovarian malignant tumors.There is limited value especially for predicting early ovarian malignant tumors.Tissue biopsy is an invasive test measure,which is not suitable for screening ovarian malignant tumors.In recent years,people have paid more attention to the diagnosis and prognosis of combined detection biomarkers in ovarian malignant tumors.It has been a research hotspot that finding combined tumor markers which have a high accuracy in diagnosing ovarian malignant tumors and a small financial burden on patients and can be used widely in clinical practice.It is found clinically that the levels of some conventional blood indicators in patients with malignant tumors are higher than patients with benign tumors and healthy people.Most patients with advanced ovarian malignancies have a high level of coagulation indexes including D-dimer(D-D)and fibrinogen(FIB),and the blood also is in a highly coagulated state.Platelet(PLT)is involved in the coagulation system and is associated with malignant ovarian tumors.This study will focus on the indicators of CA125,D-dimer,PLT,and FIB to explore the significance of combined detection indicators for the antidiastole of ovarian tumors and early diagnosis of ovarian malignancies.Purpose Compare the levels of CA125,D-dimer,PLT and FIB in the blood of patients with benign and malignant ovarian tumors,analyse the relevant data about single and combined detection indicators to diagnose benign and malignant ovarian tumors and analyse the relationship between single and combined detection indicators and the stages of ovarian malignancies to explore the clinical value of combined detection indicators in the diagnosis of ovarian malignant tumors.Methods A total of 400 patients with ovarian tumors were selected in this study who were hospitalized and underwent surgical treatments from January 2017 to December 2018 in the Second Hospital of Jilin University.They are diagnosed by postoperative pathology including 156 patients with ovarian malignant tumors and 244 patients with ovarian benign tumors.The data of serum CA125,D-dimer,PLT,FIB and related clinical data were collected by searching through the medical records.Statistical analysis was performed by using SPSS22.0 software.Results 1.The levels of CA125,D-dimer,PLT and FIB in patients with ovarian malignant tumors were higher than those in patients with ovarian benign tumors(P<0.01);the levels of every indicator in ovarian malignant tumors patients with stage Ⅲ-IV were higher than the patients with stageⅠ-Ⅱ(P <0.01),the levels of CA125 and D-dimer were significantly higher in patients with stage Ⅲ-IV ovarian malignant tumors than in patients with stageⅠ-Ⅱ(P <0.001).2.The positive rates of CA125,D-dimer,PLT and FIB in the malignant ovarian tumor group were significantly higher than that in the benign group(P<0.001).The positive rates of the combined detection indicators CA125+D-dimer,CA125+FIB,Ddimer+FIB and CA125+D-dimer+FIB in the malignant ovarian tumor group were significantly higher than that in the benign group(P<0.001);the positive rates of the single and combined detection indicators in the benign ovarian tumor group were both low.The positive rates of CA125 + D-dimer,CA125 + FIB and CA125 + D-dimer + FIB in the malignant group were higher than those of the individual indicators,and the positive rates of these combined detection indicators in the benign group also increased.3.The positive rates of CA125,D-dimer,PLT and FIB in the stage III-IV ovarian malignant tumor group were higher than those in stage Ⅰ-Ⅱ,and the difference was statistically significant(P<0.05).The positive rates of CA125 in the stage Ⅰ-Ⅱ and Ⅲ-Ⅳ ovarian tumor groups were 59.5% and 98.7% respectively.The positive rates of D-dimer in the stageⅠ-Ⅱ and Ⅲ-Ⅳ ovarian tumor groups were 26.6% and 81.8% respectively.The positive rates of PLT and FIB in the stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ ovarian malignant tumors were both low.The positive rates of combined detection indicators CA125 + D-dimer,CA125 + FIB,D-dimer + FIB and CA125 + D-dimer + FIB in stage Ⅰ-Ⅱ ovarian malignant tumor groups were 60.8%,64.6%,35.4% and 65.8% respectively,and the positive rates in stage III-IV were 98.7%,98.7%,85.7% and 98.7% respectively;the positive rates of the combined detection indicators were higher than that of the single detection indicator in stage III-IV,and the false positive rate of the combined detection indicators were also higher.4.The levels of CA125,D-dimer,PLT,and FIB in patients with ovarian malignant tumors were positively correlated with their stage(P <0.05);the levels of CA125,Ddimer,PLT and FIB in patients with ovarian malignant tumors showed a positive correlation between any two indicators(P <0.001).5.The differences of CA125,D-dimer,PLT and FIB levels between epithelial and non-epithelial ovarian malignant tumor groups and benign ovarian tumor groups were statistically significant(P <0.01).The ovarian tumor groups were compared between evey two groups.The levels of CA125,D-dimer,PLT and FIB in the epithelial ovarian malignant tumor group were higher than those in the ovarian benign tumor group(P <0.001).The levels of CA125,D-dimer and FIB in the epithelial ovarian malignant tumor group were higher than those in the non-epithelial ovarian malignant tumor group(P <0.001),but there was no significant difference for the PLT levels between the two groups(P> 0.017).The level of FIB in non-epithelial ovarian malignant tumor group was higher than that of the benign ovarian tumor group(P <0.01),but there was no statistically significant difference for the levels of CA125,D-dimer and PLT between the two groups.6.Among patients with ovarian malignant tumors,the levels of CA125,D-dimer,and FIB in those with ascites were higher than those without ascites(P<0.001),and there was no significant difference for the level of PLT between those with and without ascites(P>0.05);among patients with ascites ovarian malignant tumors,the level of CA125 was significantly higher in the ascites cytology-positive group than in the ascites cytology-negative group(P<0.05),but there were no significant differences for the levels of D-dimer,PLT and FIB between the positive and negative groups of ascites cytology(P>0.05).7.In the benign ovarian tumor group,the levels of CA125 and PLT in the premenopausal group were higher than those in the postmenopausal group(P<0.05).The level of FIB in the postmenopausal group was higher than that in the premenopausal group(P <0.01).There were no statistically significant differences for the levels of D-dimer between the premenopausal group and postmenopausal group(P>0.05).In the ovarian malignant tumor group,the levels of all indicators were not statistically significant between the premenopausal group and postmenopausal group(P>0.05).In the epithelial and non-epithelial ovarian malignant tumor groups,there were no statistically significant differences for the levels of CA125,D-dimer,PLT and FIB(P>0.05).8.The cut-off values of CA125,D-dimer,PLT and FIB were 52.9U/ ml,0.51ug/ml,327.5*109 /L and 3.41g/L respectively,the sensitivity of each single detection indicator to diagnose benign and malignant ovarian tumors was 75.0%,80.8%,32.7% and 66.0%,with the specificities of 93.9%,86.5%,87.7% and 78.5% respectively,and the sensitivity of PLT was the lowest;the AUCs of CA125,D-dimer,PLT and FIB were 0.869、0.864、0.591 and 0.776 respectively.The diagnostic accuracies of CA125,Ddimer and FIB for benign and malignant ovarian tumors were moderate,and the accuracy of PLT was lower.The sensitivities of combined detection indicators CA125 + D-dimer,CA125 + FIB,D-dimer + FIB and CA125 + D-dimer + FIB for the diagnosis of benign and malignant ovarian tumors were 86.5%,75.0%,79.5% and 81.4%,respectively,with the specificities of 83.6%,93.9%,87.7% and 90.6% and with the AUCs 0.899,0.876,0.864 and 0.910 respectively.CA125 + D-dimer and CA125 + Ddimer + FIB were more accurate for the antidiastole of benign and malignant ovarian tumors.The sensitivities of the combined detection indicators to diagnose benign and malignant ovarian tumors were higher than that of the single detection indicators,and the diagnostic accuracies were higher than that of the single detection indicators.9.The sensitivities of single detection indicators CA125,D-dimer,PLT and FIB were 88.3%,81.8%,48.1% and 51.9% respectively for the antidiastole of early and advanced ovarian malignancies,with specificities of 69.6%,73.4%,73.4%,and 73.4% respectively.The sensitivities of combined detection indicators CA125 + D-dimer,CA125 + FIB,D-dimer + FIB and CA125 + D-dimer + FIB for the antidiastole of early and advanced ovarian malignancies were 92.2%,93.5%,85.7% and 94.8% respectively,with specificities of 63.3%,58.2%,64.6%,and 55.7% respectively.The sensitivities and negative predictive values of the combined detection indicators to identify the stage of ovarian malignant tumors were higher than that of single detection indicators.Conclusion 1.The levels of blood test indicators CA125,D-dimer,PLT and FIB were related to the nature of ovarian tumors.2.The levels of blood test indicators CA125,D-dimer,PLT and FIB were related to the stage of ovarian malignant tumors.3.Among patients with malignant ovarian tumors,the levels of blood test indicators CA125,D-dimer,and FIB were higher in patients with ascites than in patients without ascites.4.The value of combined detection indicators for the antidiastole of benign and malignant ovarian tumors was better than that of single detection indicators.The combined detection indicators CA125+D-dimer and CA125+D-dimer+FIB had better diagnostic efficiencies for the antidiastole of benign and malignant ovarian tumors.5.The positive rates of the combined detection indicators in early ovarian malignant tumors were higher than that of the single detection indicators,and the sensitivities of the combined detection indicators to identify the stage of ovarian malignant tumors were higher than that of the single detection indicators,suggesting that the combined detection indicators had more clinical significance in diagnosing the stage of ovarian malignant tumors. |
PDF Full Text Request