A Study For The Clinical Application Value Of Color Doppler Ultrasound,CA125,HE4 And ROMA To Diagnose Ovarian Tumor

Objective: Ovarian cancer with poor prognosis and high mortality. Early detection, early diagnosis, early treatment are the principle of the optimal management of ovarian cancer. This study aims to investigate ovarian cancer diagnosis methods: the Clinical Application Value of Color Doppler Ultrasound, CA125, HE4 and ROMA, with the purpose of provide the reliable reference to diagnose the Ovarian Cancer and Ovarian Benign Tumor.Methods: Take a total of 298 inpatients including 64 ovarian cancer cases and 234 ovarian benign tumor cases, and 46 cases of normal women as the research objects in the time of2014.2-2015.3 who visited the Gansu Province Hospital. Collected the report of Color Doppler Ultrasound, the value of CA125、HE4 and ROMA index.The diagnostic standard is the postoperative pathological results. Calculated the Sensitivity and specificity and so on of all the diagnosis methods.Results:1. Patients with pelvic masses age distribution: 10 ~ 84 years, the average age was40.33±13.79 years, premenopausal 246 cases, postmenopausal 52 cases. Ovarian Cancer 64 cases, Ovarian Benign Tumor 234 cases.2. The levels of HE4,CA125 and the value of ROMA in ovarian cancer group were statistically significantly higher than the ovarian benign tumor group and control group( P=0.000,0.000,0.000﹤0.05).3. But there were no significant differences between ovarian benign tumor group and control group.(P =0.075,0.885,0.886> 0.05).4. The serum of CA125, HE4, ROMA and Color Doppler Ultrasound, Color Doppler Ultrasound & ROMA, all the diagnosis methods have misdiagnosis phenomena.5. Color Doppler ultrasound has higher diagnose accordance rate(91.88%) and negative predictive value(92.27%).6. The serum of CA125 has higher negative predictive value(92.73%).7. The serum of HE4 has higher specificity(92.73%).8. For the female pelvic masses, ROMA showed the good diagnosis performance,especially for the postmenopausal women, ROMA show more advantage.9. Drew ROC curve of CA125, HE4, ROMA, Calculate the area under the curve. The result were 0.857,0.823,0.846(P =0.000,0.000,0.000﹤0.05),all >0.8,that is show alone use CA125, HE4, ROMA, to Diagnose the Ovarian Cancer and Ovarian Benign Tumor also have higher accuracy.10. According to ROC curve of CA125, HE4, Finding the maximum value of CA125 youden index. It is 0.617, the corresponding CUT-OFF value were 72.66U/ml; same methods,Finding the maximum value of HE4 youden index. It is 0.683, the corresponding CUT-OFF value were 64.50pmol/L.11. ROMA and color Doppler ultrasound combined in the prediction and diagnosis of ovarian cancer were higher than alone, the diagnostic specificity,negative predictive value were84.38%,95.12%.Conclusion:1. Using the serum of CA125 to diagnose the Ovarian Cancer and Ovarian Benign Tumor, suggest take 72.66U/ml as the CUT-OFF values.2. Using the serum of HE4 to diagnose the Ovarian Cancer and Ovarian Benign Tumor,suggest take 64.50pmol/L as the CUT-OFF values.3. Alone using CA125, HE4, ROMA, to Diagnose the Ovarian Cancer and Ovarian Benign Tumor also have higher accuracy, But for the postmenopausal women, ROMA show more advantage.4. ROMA and color Doppler ultrasound combined in the prediction and diagnosis of ovarian cancer were higher than alone, it has clinical value.