The Study On The Clinical Value Of CA19-9、CA125 And CA72-4 In Ovarian Mucinous Tumor

Objective: To explore risk factors of influencing the pathological nature(benign,borderline and malignant)of ovarian mucinous tumor;Develop and estimate the prediction model with the diagnosis of the borderline and malignant ovarian mucinous tumor;Evaluate the diagnostic value of CA19-9(carbohydrate antigen 19-9,CA19-9),CA125(carbohydrate antigen 125,CA125)and CA72-4(carbohydrate antigen 72-4,CA72-4)on malignant ovarian mucinous tumor,in order to provide clinical guidance for the early diagnosis and treatment of patients.Methods: A total of 466 patients’ data with ovarian mucinous tumor in our hospital from January 2019 to October 2020 were collected and divided into three groups: benign group(321 cases,68.90%),borderline group(103 cases,22.10%)and malignant group(42 cases,9.01%)according to postoperative pathology.Patient clinicopathologic data which includes patient demographics,clinical manifestation,serum tumor markers and tumor-specific factors were collected and analyzed.Multivariate Ordinal Logistic regression analysis was used to explore risk factors of the pathological nature in ovarian mucinous tumor and build the nomogram.Concordance index(C-index),calibration plots and Decision Curve Analysis(DCA)were applied to estimate the model.Receiver operating characteristic(ROC)curve and the area under the curve(AUC)were performed to evaluate the diagnostic value of these markers including CA19-9、CA125、CA72-4 on malignant ovarian mucinous tumor.Results: 1.Univariate analysis showed that there were significant differences in age,menopause,abdominal pain,abdominal distension,the positive rate of CA19-9,the positive rate of CA125,the positive rate of CA72-4,tumor size,bilateral involvement,torsion or rupture in benign group,borderline group and malignant group(P< 0.05)(Table 1).The serum levels of CA19-9、CA125、CA72-4 were significant differences in benign group,borderline group and malignant group(P< 0.05)(Table 2).2.Multivariate Logistic regression analysis showed that CA19-9 positive(OR=2.193;95%CI:1.314-3.661),CA125 positive(OR=2.777;95%CI:1.684-4.580)and CA72-4 positive(OR=2.345;95%CI:1.459-3.770)were independent risk factors for pathological nature upgrade of ovarian mucinous tumors(Table 2).3.The final model consisted of CA19-9、CA125、CA72-4(Figure 1).The C-index was0.764(95%CI,0.715～0.813)(Figure 2).The model showed good discrimination and good calibration.Decision curve analysis demonstrated that the model was also clinically useful.4.In the malignant group,the AUC of CA19-9,CA125,CA72-4 and the combined detection of CA19-9,CA125 and CA72-4 were 0.669(0.570-0.768),0.755(0.674-0.836),0.771(0.695-0.848)and 0.776(0.694-0.858),respectively.CA19-9 showed the highest specificity(79.01%).The combined detection of three tumor markers showed the highest sensitivity(80.95%)(Table 4 and Figure 4).Conclusion: In this study,CA19-9,CA125 and CA72-4 are independent risk factors of the pathological nature of ovarian mucinous tumor.This study presents a good model that may facilitate prediction for the diagnosis of the borderline and malignant ovarian mucinous tumor.The combined detection of CA19-9,CA125 and CA72-4 can improve the diagnostic efficiency of malignant ovarian mucinous tumor and thus,may help the early diagnosis and individualized management of ovarian mucinous tumor.