Study On The Value Of CA125 And HE4 Combined MR In The Diagnosis Of Ovarian Cancer

ObjectiveObjective to explore the value of combined application of CA125,HE4 and magnetic resonance imaging in the diagnosis of epithelial ovarian cancer.MethodsThe 98 cases of ovarian epithelial tumor in Affiliated Hospital of Tai'an Medical College from September 2013 to September 2016 were selected.The pelvic MRI and CA125,HE4 levels and malignant tumor staging,clinical manifestation and clinicopatho-logical features were analyzed retrospectively in 98 patients.According to the malignant degree of the tumor,it was divided into the observation group?30 cases of ovarian malign-ant epithelial tumor?,of which 11 cases in the early stage?stage I,stage II?,19 cases in the late stage?stage III,IV?,and the control group?68 cases of ovarian benign epithelial tumor group?,the serum CA125 and HE4 level of the 2 groups were detected respectively,and the pelvic MRI examination was performed to draw the subjects'work special.Receiver operator characteristic?ROC?curve,calculate the area under the curve?area under the curve,AUC?,compare the area and sensitivity and specificity under the ROC curve of each and three joint tests,and analyze the value of various methods for the judgement of ovarian malignant tumor.Results1.the average age of the 1.observation group and the ovarian control group were?55.47±9.75?years and?43.58±14.30?years,and the two groups were statistically different?P<0.05?.The average age of the two groups was?44.22±3.49?years old vs?36.65±10.80?years,and the two groups were statistically different?P<0.05?;the ratio of the menopause patients in the observation group was more than that of the observation group.The proportion of cases?19/30 cases?and menopausal women in ovarian control group?9/68 cases?was statistically different?P<0.05?.There was no significant difference in age of onset between the two groups of menopausal women.The mean values of CA125 in the two groups were?559.47±440.58?U/ML vs.?38.48±93.41?U/ML and P<0.05,respectively.The mean values of HE4 were?297.94±353.39?pmol/L vs.?44.29±23.37?pmol/L,P<0.05,there was statistical difference.2.The mean values of CA125 in the two groups were?559.47±440.58?U/ML vs.?38.48±93.41?U/ML,respectively,and there was statistical difference?P<0.05?.The mean values of HE4 were?297.94±353.39?pmol/L vs.?44.29±23.37?pmol/L,respectively,and there was statistical difference?P<0.05?.3.The size of ovarian tumor?8.21±3.96?cm vs.?9.15±4.22?cm in the observation group and the control group was not statistically different?P>0.05?.The average diameter of the solid part of the tumor in the observation group and the control group were?2.78±0.58?cm vs.?1.40±0.74?cm,P<0.05,and there were statistical differences?P<0.05?.4.The ADC value of ROI in the observation group was?0.982±0.325?x10^-3mm²/s,and the control group was?2.545±0.631?x 10^-3mm²/s.The values of the two groups were statistically different?P<0.01?.The eADC value of the observation group was?3.714±0.905?x10^-3mm²/s.The control group was?1.125±0.773?x 10^-3mm²/s.The values of the two groups were statistically different?P<0.01?.5.The differences of bilateral tumor?15/30,10/68?and ascites?6/30,2/68?between the observation group and the control group were statistically different?P<0.01?.The swelling of the observation group was 13.33%?4/30?,and the tumor in the control group was 94.12%?64/68?,and the difference was statistically significant?x ²=14.3,P<0.01?.6.The sensitivity of the combined detection of two tumor markers?91.2%?was higher than that of CA125 and HE4?86.7%,80%?,and the specificity?76.7%?was higher than the specificity of CA125 single test?73.3%?.The sensitivity of combined detection of HE4 and CA125?91.2%?was higher than the sensitivity of magnetic resonance imaging?82.4%?.The specificity of combined detection of HE4 and CA125?76.7%?was higher than that of MRI?73.3%?.7.The joint inspection of MR+CA125+HE4 three AUC is 0.994?95%CI:0.982-1?,CA125 AUC 0.914?95%CI:0836-0.993?,MR AUC 0.915,?95%CI:0.847-0.983?,HE40.894,0.957.The value of combined diagnosis of three is higher than the value of single detection.8.The sensitivity of combined detection of three was 94.1%,which was 86.7%,80%,82.4%,?²=278.23,P<0.01.of CA125,HE4 and MRI respectively,and the difference was statistically significant.The specificity of combined detection between the three was89.1%,which was 82.4%,88.2%,73.3%,?²=284.24,P<0.01,which were significantly higher than those detected by CA125,HE4 and MRI,and the difference was statistically significant.ConclusionThe sensitivity,specificity and diagnostic value of the combined examination of CA125,HE4 and pelvic nuclear magnetic resonance imaging?MRI?three are superior to that of CA125,HE4 and pelvic MRI alone.It has important clinical value in the diagnosis of ovarian epithelial carcinoma.