Application Of Preoperative Peripheral Blood Combined Detection Of Multiple Indexes In The Diagnosis Of Ovarian Tumor

Objective:To analyze the differences of preoperative peripheral blood CA125,HE4,CA724,CYFRA21-1,NSE and HALP in benign and malignant ovarian tumors,and to explore the value of individual and combined detection of each index in distinguishing benign and malignant ovarian tumors and in the staging of malignant tumors.Methods:A retrospective analysis was made on 147 patients with ovarian malignant tumors initially diagnosed and pathologically diagnosed in the Second Hospital of Jilin University from January 1,2020 to December 31,2021,they were set as ovarian malignant tumor group and 146 patients with benign ovarian tumors as ovarian benign tumor group.The clinical data such as age,menopausal status,histological classification and FIGO stage of ovarian tumors,preoperative serum CA125,HE4,CA724,CYFRA21-1 and NSE were collected and statistically analyzed.Results:1.In ovarian malignant tumor group,the levels of CA125,HE4,CA724,CYFRA21-1 and NSE were higher than those in benign group,while the level of HALP was lower than that in benign group（P<0.001）.2.There were differences in the levels of CA125,HE4,CA724,CYFRA21-1,NSE and HALP among the benign ovarian tumor group,early ovarian malignant tumor group and advanced ovarian malignant tumor group（P<0.001）.3.Compared with benign ovarian tumor group,the positive rates of CA125,HE4,CA724,CYFRA21-1,NSE,HALP,CA125+HE4,CA125+HE4+CA724,CA125+HE4+CYFRA21-1,CA125+HE4+NSE and CA125+HE4+HALP in malignant group were higher（P<0.001）.Compared with the single index in malignant group,the positive rate of combined index was higher as a whole.4.Compared with early ovarian malignant tumor group,the positive rates of CA125,HE4,CA724,CYFRA21-1,NSE,HALP,CA125+HE4,CA125+HE4+CA724,CA125+HE4+CYFRA21-1,CA125+HE4+NSE and CA125+HE4+HALP in advanced group were higher（P<0.05）.In the advanced group,the positive rate of combined indexes was 100%.5.Ovarian malignant tumors were divided into epithelial group and non epithelial group according to histopathology.Compared with non epithelial group,the levels of CA125,HE4,CA724 and CYFRA21-1 in epithelial group were higher（P<0.05）.6.The overall patients were divided into premenopausal and postmenopausal subgroups according to menopausal status.No matter in premenopausal patients or postmenopausal patients,in ovarian malignant tumor group,the levels of CA125,HE4,CA724 and CYFRA21-1 were higher than those in benign group（P<0.01）,and the level of HALP was lower than that in benign group（P<0.001）,there was no statistical difference in NSE（P=0.151 before menopause,P=0.063 after menopause）.7.The sensitivity of CA125,HE4,CA724,CYFRA21-1,NSE and HALP in the differential diagnosis of benign and malignant ovarian tumors were 81.0%,73.5%,66.7%,63.3%,32.0%and 55.8%respectively,the specificity was 92.5%,91.1%,61.0%,97.3%,93.2%and 80.8%respectively,and the AUC was 0.884,0.888,0.666,0.860,0.630 and 0.714 respectively.The accuracy of CA125,HE4 and CYFRA21-1 in the diagnosis of ovarian malignant tumors is relatively good,the accuracy of HALP in the diagnosis of ovarian malignant tumors is medium,and the accuracy of CA724 and NSE is low.The AUC of the combined indexes CA125+HE4,CA125+CYFRA21-1,HE4+CYFRA21-1,CA125+HE4+CYFRA21-1,CA125+HE4+CA724,CA125+HE4+NSE and CA125+HE4+HALP in the differential diagnosis of benign and malignant ovarian tumors were 0.928,0.929,0.912,0.943,0.928,0.928 and 0.930 respectively,the sensitivity was 84.4%,78.9%,80.3%,84.4%,84.4%,84.4%and 84.4%,and the specificity was 91.8%,95.9%,91.1%,93.8%,91.8%,91.8%and 92.5%,respectively.The AUC of each joint detection index is greater than 0.9,with high accuracy.The specificity of each combined detection index was greater than 90.0%,which was not significantly lower than that of the single detection index,the sensitivity was improved as a whole,and the AUC was higher than that of the single detection index.8.The sensitivity of CA125,HE4,CA724,CYFRA21-1,NSE and HALP in the differential diagnosis of early and late stage ovarian malignant tumors were 79.3%,91.4%,48.3%,79.3%,65.5%and 58.6%respectively,the specificity was 79.8%,71.9%,74.2%,82.0%,67.4%and 70.8%respectively,and the AUC was 0.859,0.851,0.612,0.818,0.686 and 0.662 respectively.The accuracy of CA125,HE4 and CYFRA21-1 in the differential diagnosis of early and advanced ovarian malignant tumors is relatively good,while the accuracy of CA724,NSE and HALP is low.The AUC of the combined indexes CA125+HE4,CA125+CYFRA21-1,HE4+CYFRA21-1,CA125+HE4+CYFRA21-1,CA125+HE4+CA724,CA125+HE4+NSE and CA125+HE4+HALP in the differential diagnosis of early and late stage ovarian malignant tumors were 0.874,0.870,0.862,0.875,0.880,0.875 and 0.867 respectively,the sensitivity was 86.2%,82.8%,84.5%,82.8%,84.5%,86.2%and 84.5%,and the specificity was 77.5%,79.8%,80.9%,79.8%,78.7%,77.5%and 78.7%,respectively.The AUC of each combined index has little difference,which is higher than that of the single index as a whole,the sensitivity of each combined index is higher than that of the single index as a whole,and compared with the single index,the specificity is not significantly lower.Conclusion:1.Preoperative peripheral blood detection indexes CA125,HE4,CA724,CYFRA21-1,NSE and HALP were related to the quality and stage of ovarian tumors,the levels of CA125,HE4,CA724 and CYFRA21-1 were related to the histological classification of ovarian malignant tumors.2.The diagnostic efficacy of combined index is better than that of single index in differentiating benign and malignant ovarian tumors,the diagnostic efficacy of combined index is also better than that of single index in differentiating early and advanced ovarian malignant tumors.