| Objective:The serum glycoprotein 125,human epididymal secretory protein 4,glycoprotein antigen 199 and MRI indexes of ovarian malignant tumor group and ovarian benign tumor group were analyzed statistically to evaluate the diagnostic value of serum tumor markers and MRI on ovarian malignant tumor.Method:A retrospective analysis of 147 ovarian disease cases collected from June 2017 to December 2019.All patients had undergone CA125,CA199,HE4,and MRI examinations before surgery.There were 70 cases of ovarian malignant tumors confirmed by pathology.There were 77 cases.The clinical characteristics of benign and malignant ovarian tumors,CA125,CA199,HE4,and MRI-related data were statistically analyzed,and pathological results were used as the gold standard to calculate CA125,HE4,MRI,CA125+HE4,HE4+MRI,CA125+MRI,CA125+HE4+The sensitivity,specificity,coincidence rate,Jordan index,false negative rate,and false positive rate of MRI in the diagnosis of ovarian malignant tumors.Statistical analysis of differences in detection rates of various detection methods in ovarian malignancies.Result:1.The age of ovarian malignant tumor group(56±12)was 9 years older than that of benign tumor group(42±16)(P<0.050),and the difference was statistically significant.The number of symptoms in the malignant tumor group(84.3%)was more than that in the benign tumor group(54.5%)(P<0.050),and the difference was statistically significant.There were more vaginal bleeding cases in the malignant group(62.9%)than in the benign group(37.7%)(P<0.05),and the difference was statistically significant.There were more cases of abdominal distension in the malignant group(28.6%)than in the benign group(11.7%)(P<0.05),and the difference was statistically significant.The frequency of urinary frequency/urgency in the malignant group was 11 in the malignant group.The number of urinary frequency/urgency in the benign group was 0(P<0.05).There were no significant differences in the clinical symptoms of menstrual changes,abdominal pain,spontaneous cramps and masses in benign and malignant tumors(P>0.05).2.Whether the lesions were bilateral in MRI features of benign and malignant ovarian diseases(P>0.05),there was no significant difference.In the malignant group,there were more cases of cystic solid on MRI(85.7%)than in the benign group(30.0%)(P<0.05),and the difference was statistically significant.In the malignant group,the number of cases with significantly uneven enhancement on MRI(81.4%)was more than that in the benign group(13.0%)(P<0.05),and the difference was statistically significant.Nine patients with malignant ovarian lesions had pelvic lymphadenopathy,peritoneal and omental metastases,but no metastases occurred in benign ovarian diseases(P<0.05).The difference was statistically significant.3.CA125、HE4 levels in benign and malignant ovarian tumors were compared(P<0.001),the differences were statistically significant,and the CA125、HE4 levels in malignant ovarian tumors were significantly higher than those in benign ovarian diseases.There was no significant difference between CA199 levels in benign and malignant ovarian tumors(P>0.05).4.The diagnostic sensitivity of CA125,HE4,MRI,CA125+HE4,HE4+MRI,CA125+MRI,CA125+HE4+MRI is 84.3%,67.1%,77.1%,90.3%,90%,88.6%,95.7%The specificity is 75.3%,96.1%,98.7%,100%,100%,100%,100%,and Yoden index are:0.60,0.63,0.76,0.93,0.90,0.87,0.96.5.The detection rate of CA125 in ovarian malignancies is higher than HE4,MRI+CA125 is higher than MRI,MRI+HE4 is higher than HE4,CA125+HE4 is higher than HE4,CA125+HE4 is higher than MRI,and MRI+CA125+HE4 is higher than MRI,MRI+CA125+HE4 was higher than HE4,MRI+HE4+CA125 was higher than MRI+HE4(P<0.05),and the differences were statistically significant.CA125 detection rate compared with MRI,HE4 and MRI,CA125 and MRI+HE4,CA125 and CA125+HE4,CA125 and MRI+CA125,MRI and MRI+HE4,CA125 and MRI+CA125+HE4 compared,CA125+HE4 compared to MRI+CA125,MRI+CA125 compared to MRI+HE4,MRI+HE4 compared to CA125+HE4,MRI+HE4+CA125 compared to CA125+HE4,MRI Compared with MRI+CA125+HE4+CA125(P>0.05),the differences were not statistically significant.6.In the diagnosis of benign and malignant ovarian tumors,the area under the ROC curve of CA125 is 0.857,and the 95%confidence interval(0.796,0.919),CA125 has certain diagnostic value.When the critical value is 45.04U/ml,the sensitivity and specificity are 82.9%,77.9%.The area under the ROC curve of HE4 is 0.904,the 95%confidence interval(0.815,0.959).When the critical value is 80.17 pmol/L,the sensitivity and specificity are 82.9%and 96.1%,HE4 has high diagnostic value.The area under the ROC curve of CA125+HE4 is 0.941,with 95%confidence intervals(0.903,0.979),which has high diagnostic value.Conclusion:1.Patients with ovarian malignant tumors have more symptoms than benign patients.Vaginal bleeding,abdominal distension,frequent urination,and urgency can be used as reference indicators for ovarian malignant tumors.2.CA125 has high sensitivity,low specificity,low HE4 sensitivity and high specificity.The two lack complementary advantages.CA125+HE4 has higher sensitivity and specificity,which is expected to become an ideal diagnostic method.3.CA199 is more sensitive to ovarian mucinous cancer,and the combination of CA199 and CA125 can improve the diagnosis of ovarian cancer.4.MRI is of great significance for the diagnosis of benign and malignant ovarian tumors,and the sensitivity,coincidence rate and Jordan index of MRI CA125HE4 are the highest,which is the best diagnostic method among all the examination methods in this paper.5.Cystic solidity is the most important MRI sign to predict ovarian malignancy.MRI can better reflect the biological characteristics of the focus,can provide a reliable reference for preoperative staging,clinical treatment and prognosis evaluation,is an irreplaceable tumor marker. |
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