Clinical Analysis Of Differential Diagnosis Between Pelvic Tuberculosis And Ovarian Cancer

Objective:To analyze the differences in age,clinical manifestations,auxiliary examination and surgical exploration data of female pelvic tuberculosis and ovarian cancer patients and explore the key points of differential diagnosis between the two groups of diseases.Methods:Select tumor hospital of Shanxi Province from January 2012 to July 2020 were confirmed by pathology during 112 cases of patients with pelvic tuberculosis(89 of them underwent surgical pathology confirmed,23 underwent biopsy confirmed),224 patients with ovarian cancer were performed surgical pathology confirmed,collection of two groups of patients admitted to hospital with general information,clinical manifestation,imaging examination,serum tumor markers and intraoperative exploration results,on the basis of the collected data,select the appropriate statistical methods,comparing the difference between two groups of patients in various aspects.Results:1.By means of two groups of patients with general data were retrospectively analyzed,the results showed that the incidence of pelvic TB group age was 42.20±14.86 years of age,the incidence of ovarian cancer group age was 56.16 ±10.03 years old,can be seen,the incidence of pelvic TB patients,younger patients with ovarian cancer older,two groups of patients with the onset of age difference statistically(P < 0.001);2.In terms of clinical manifestations,pelvic tuberculosis patients may have primary infertility,fever,night sweats and other specific manifestations of tuberculosis,but abdominal distension,loss of appetite and pelvic mass are still the main clinical first symptoms,as is the case with ovarian cancer,the difference between the two was not statistically significant(P > 0.05);3.In terms of tumor marker analysis,serum levels of CA125,HE4 and CA724 in the ovarian cancer group were higher than those in the pelvic tuberculosis group,and the difference was statistically significant(P < 0.001);4.ROC curve analysis showed that CA125,HE4 and CA724 had the highest area under the curve(AUC=0.43)and the detection rate was 85.7% at the cutoff value of92.54pmol/L.Therefore,the detection rate of HE4 was higher in the prediction of ovarian cancer;5.Imaging examination results showed that there were differences in mass types between the two groups(P < 0.05).In the pelvic tuberculosis group,cystic mass was more common,but no obvious internal blood flow was seen;in the ovarian cancer group,cystic solid mass was more common,and rich blood flow signal was seen in the solid area.Lymphatic metastases in the mesenteric lymph nodes were more common in the pelvic tuberculosis group,and most of the lymphatic metastases in the ovarian cancer group were retroperitoneal lymph nodes,accounting for 40.18% and55.36% of the qualified cases included in this study,respectively,and the difference was statistically significant(P < 0.001);6.During surgical exploration,there was no significant difference in the volume of ascites between the two groups(P > 0.05),but there were significant differences in the appearance and nature of ascites(P < 0.001).Conclusions:The onset age of patients with pelvic tuberculosis is younger than that of ovarian cancer,and the clinical manifestations of patients in the two groups are similar,often manifested as abdominal distension,loss of appetite,and pelvic mass,but some pelvic tuberculosis patients may also show specific symptoms of tuberculosis,namely fever,night sweats,and primary infertility.The serum level of CA125 in patients with pelvic tuberculosis was abnormally elevated,while the expression of HE4 and CA724 was low or not expressed.Imaging showed pelvic cystic mass with enlarged mesenteric lymph nodes.Compared with other assays,ascites cytological qualitative examination showed significant advantages in diagnosing pelvic tuberculosis and ovarian cancer.All clinical data were comprehensively evaluated,among which,young women,febrile night sweats,abdominal distension and abdominal pain,pelvic cystic mass,positive CA125 and negative HE4 could be used as the primary diagnosis points of pelvic tuberculosis.