Application Of Ultrasound, Retinol-Binding Protein 4 And CA125 In Diagnosis Of Ovarian Cancer

Objective:To explore the clinical value of ultrasound, serum retinol-binding protein 4 (RBP4) and cancer antigen 125 (CA125) in diagnosis of ovarian cancer.Methods:The patients with ovarian tumor from May.2013 to Jan.2014 were analyzed, among whom all received ultrasound examination, RBP4 and CA125 detection one week before surgery. All the masses were confirmed by histopathological examination after surgery.20 healthy women examined in Medical Center of our hospital were selected as controls at the same period. By using a special enzyme immunoassay kit, their levels of serum RBP4 were measured. According to the ultrasound-based scoring system, patients were classified into groups:Patients with ovarian masses of a score^6 were considered to be suspicious malignancy, while patients with ovarian masses of a score<6 were considered to be suspicious benign.Results:116 ovarian masses in ninety-six patients were detected in this study. Confirmed by pathohistology, among those 116 ovarian masses,49 of which in 41 cases were epithelial ovarian cancer, the rest 67 masses in 55 cases were epithelial benign ovarian tumor. The suspicious malignancy group included 40 cases,36 (90%) were malignant, and 4 (10%) were benign. The suspicious benign group included 56 cases,51 (91.1%) were benign, and 5 (8.9%) were malignant. The levels of RBP4 were significantly lower in epithelial ovarian cancer group (23.73±7.72)μg/ml than that in epithelial benign ovarian tumor group(36.50±7.58)μg/ml and healthy control group (39.73±5.64)μg/ml (P< 0.001). And the levels of RBP4 were no significant difference between epithelial benign ovarian tumor group and healthy control group (P=0.095).The receiver operating characteristic curve (ROC curve) showed that when the best cut-off of RBP4 was 29.52μg/ml, the sensitivity, specificity, Youden’s index in diagnosis of ovarian cancer was 85.4%,81.8% and 0.67 respectively. The sensitivity, specificity, Youden’s index of CA125> 35U/ml in diagnosis of ovarian cancer was 80.5%,67.3% and 0.48 respectively. When the ultrasound, RBP4, CA125 were put into separately use, the sensitivity, specificity, Youden’s index of ultrasound in diagnosis of ovarian cancer reached highest, rising to 87.8%, 92.7% and 0.81 respectively. Comparing with the separate use, the sensitivity in joint examinations was higher. Meanwhile, with the combination of RBP4 and ultrasound, the sensitivity, specificity, Youden’s index reached 95.1 ,76.4% and 0.72 respectively.Conclusion:1.The ultrasound-based scoring system is of great value in the diagnosis of ovarian cancer.2. The levels of RBP4 were significantly reduced in epithelial ovarian cancer and could conduce to the diagnosis of epithelial ovarian cancer.3. RBP4 is expected to have an advantage of raising the diagnostic rate of epithelial ovarian cancer.4. The sensitivity of diagnosis of ovarian cancer can be improved under the combined detection of ultrasound, RBP4 and CA125. Also, the combination of RBP4 and ultrasound can improve the accuracy in diagnosis of epithelial ovarian cancer.