| Background and ObjectiveOvarian tumor is a common gynecological tumor with a wide range of types and age distribution.Ovarian cancer is located in the pelvic cavity.The early symptoms of ovarian malignant tumors often lead to undetected.When the discomfort symptoms appear,it is almost to the late stage.There is often widespread metastasis in the pelvic cavity and abdominal cavity,which leads to the missing of the best treatment period.The treatment and prognosis are poor,and the recurrence rate is high.It has been reported that the 5-year survival rate of ovarian cancer is 90%,70%,40%and 20%respectively in stage I,stage Ⅱ,stage Ⅲ and stage IV,if it can be improved High early screening rate can significantly improve the survival of patients.Therefore,one of the important measures to improve the prognosis of ovarian cancer is to improve the early diagnosis rate of ovarian cancer and early individualized treatment.The mechanism and etiology of ovarian malignancies are still ambiguous and lack of specific early screening methods.This article collects medical records of patients with ovarian tumors in the gynecology department of our hospital for the first time,analyzes the inpatient structure of ovarian tumor patients in our hospital,explores the clinical characteristics of ovarian tumors,and screens out the relevant risk factors for the occurrence of ovarian malignant tumors in order to find valuable diagnosis Indicators to provide reference and early warning for improving early clinical diagnosis of ovarian malignant tumors.Materials and Methods1.Research object:Collect and sort out the clinical medical records of 735 patients with ovarian tumors who were hospitalized for the first time in our hospital from January 2017 to February 2019 and underwent surgical treatment.Analyze the basic data of ovarian tumors,serum tumor markers and other blood indicators.2.Statistical methods:SPSS21.0 statistical software was used for data analysis.The normal distribution was expressed as mean standard deviation(x±s),the comparison between groups was expressed as t test,the non-normal distribution data was expressed as median(M)and quartile(P25,P75),and the comparison was expressed as nonparametric rank sum test.The counting data were expressed by the rate(%),and χ2 test or Fisher exact probability method was used for comparison.Logistic regression analysis was used to study the relationship between classified response variables and multiple influencing factors.Draw the receiver operating characteristic curve(ROC curve)to analyze the diagnostic value of detection indicators in the diagnosis of ovarian malignant tumors,and calculate the best cutoff value.The test level is α=0.05,with P<0.05 as the difference having statistical significance.The area under the ROC curve is between 0.5 and 1.The area under the curve(AUC)>0.9 is generally considered to have a high diagnostic value;0.7<AUC≤0.9,which has a medium diagnostic value;AUC≤0.7,which has a low diagnostic value.Results1.A total of 735 patients with ovarian tumors were first seen in our hospital from January 2017 to February 2019,with 591 benign tumor patients(80.41%),with a median age of 32 years;129 patients with malignant tumors(17.55%),with a median age of 56 Years;15 patients with borderline tumors(2.04%),with a median age of 35 years;pathological types of patients with benign tumors:203 cases(34.35%)of ovarian endometriosis,aged 32(28,39)years;ovaries 194 cases of mature cystic teratoma(32.83%),aged 29(24,37)years;71 cases of ovarian serous cystadenoma(12.01%),aged 34(28,49)years;ovarian mucinous cysts There were 56 cases(9.48%)of tumors,age 31(26.25,48.75)years old;simple ovarian cysts 49(8.29%),ages 39(27.5,47.0)years old;14 cases of ovarian fibroma(2.37%).The pathological types of patients with malignant tumors were:94 cases of ovarian serous carcinoma(72.87%),age 56(50.75,67.00)years old;6 cases of ovarian clear cell carcinoma(4.65%);5 cases of ovarian mucinous carcinoma(3.88%);ovaries There were 4 cases of adult type granulocytoma(3.1%);2 cases of ovarian endometrioid carcinoma(1.55%);2 cases of asexual cell tumor(1.55%).Among benign tumors,there were 528 non-menopausal patients,accounting for 89.34%;in malignant tumors,88 menopausal patients,accounting for 68.22%.2.The basic data of ovarian benign,borderline and malignant tumors were analyzed by single factor analysis.it was found that age,age of menarche,cumulative years of menstruation,number of pregnancies,number of births,menopausal status,educational level and marital status were significantly different among the three groups(P<0.05).There was no significant difference in ethnic distribution among the three groups(P>0.05).Multivariate Logistic regression analysis was carried out in malignant tumor group and non-malignant tumor group,and it was found that there were statistical differences between the two groups in cumulative menstrual years and menopausal status(P<0.05).No statistical difference has been found in other influencing factors(P>0.05).3.CA125,HE4 and Roma of ovarian cancer patients were significantly higher than those of ovarian benign and borderline tumor patients(P<0.05).The area of CA125,HE4 and Roma under the corresponding ROC curve before menopause was 0.745,0.855 and 0.856,respectively,and the corresponding optimal cutoff values were 97.11 u/ml,54.685pmol/1 and 9.44%;the area under the corresponding ROC curve after menopause was 0.945,0.972 and 0.968,respectively The best truncation values were 44.635u/ml,108.55pmol/1 and 36.2%respectively.4.Ferritin,CA153,CA724 and TAM in patients with ovarian malignant tumor are higher than those in patients with ovarian benign tumor(P<0.05),and the corresponding areas under ROC curve are 0.786,0.775,0.833 and 0.695 respectively,and the corresponding optimal cutoff values are 119.945μg/l,18.6 U/ml,3.14U/ml and 89.405U/ml respectively.5.The analysis of blood routine test,coagulation function and FDP,D-dimer in ovarian benign and malignant tumors showed that there were significant differences in Hb,WBC,PLT,NLR,PLR,TT,Pt,Fbg,FDP and D-dimer between the two groups(P<0.05);The area under ROC curve corresponding to the above indexes was 0.583,0.595,0.654,0.806,0.765,0.545,0.543,0.834,0.941 and 0.948,respectively;PT and TT had no diagnostic value(P>0.05);NLR,PLR,FBG,D-dimer and FDP had the best truncation values of 2.25,168.16,3.175g/1,0.605μg/ml and 3.065μg/ml,respectively.Conclusions1.From January 2017 to February 2019,the patients with gynecologic ovarian tumors in our hospital were mainly young and benign,and the pathological types were mainly endometriosis cyst and mature cystic teratoma.Ovarian malignant patients are mainly middle-aged and elderly women.The main pathology types was serous ovarian cancer.2.Menstrual accumulation and menopause are independent risk factors for ovarian malignant tumors.3.The diagnostic value of HE4 and ROMA is higher than that of CA125 alone.The diagnostic value of CA125,HE4 and ROMA after menopause is higher than that before menopause.4.Serum tumor markers iron protein,CA153,CA724 have moderate diagnostic value in ovarian malignant tumors.5.Although Hb,WBC and PLT have diagnostic value for ovarian cancer,they have low diagnostic value;NLR,PLR and FBG have medium diagnostic value;D-dimer and FDP have high diagnostic value. |
