Clinical Significance Of Plasma D-dimer Combined With Serum CA125 In The Diagnosis Of Epithelial Ovarian Cancer Recurrence

Objective: To investigate the clinical significance of plasma D-dimer and serum carbodydrate antigen 125(CA125)in the diagnosis of epithelial ovarian cancer recurrence.Methods: A total of 101 patients with epithelial ovarian cancer who underwent surgery at Shengjing Hospital of China Medical University on January 1,2011 to December 31,2018 were selected.Detailed first recurrence information is available for these patients.Complete follow-up information was collected from 30 patients without recurrence.The plasma levels of D-dimer and the serum level of CA125 were compared between the recurrent group and the non-recurrent group at the time of follow-up.Univariate and multivariate Logistic regression models were constructed to analyze the relationship between the age of ovarian cancer,neoadjuvant chemotherapy,clinical histopathological type,histilogical grade,clinical stage,and preoperative ascites.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficacy of D-dimer and CA125 for ovarian cancer recurrence and the diagnostic value of the combined diagnosis.Results: The plasma levels of D-dimer and the serum levels of CA125 in the recurrence group were higher than those in the non-recurrence group,with statistically significant differences.The serum levels of CA125 and the plasma levels of D-dimer in patients with recurrent ovarian cancer were 78.2% and 61.4% respectively;the specificity was 93.9% and 80.0% respectively,and the accuracy was 79.2% and 65.6% respectively.Among them,the sensitivity(88.1%)of CA125 and D-dimer parallel detection was higher than that of the two indexes alone,and no obvious misdiagnosis was found in CA125 and D-dimer series detection.ROC curve show D-dimer and CA125 in ovarian cancer recurrence has high testing efficiency,the area under the curve of CA125 in the diagnosis of 0.931(sensitivity was 77.2%,96.7%),the area under the curve of the D-dimer diagnosis was 0.783(sensitivity was 58.4%,90.9%),joint multiariable Logistic regression model diagnosis area under the curve is 0.945(sensitivity was 85.1%,96.7%).Among them,the increase of plasma D-dimer was more significant increase in patients aged over 55 years of recurrence than in patients younger than 55 years of recurrence,and the serum CA125 level was significantly increased in high-grade epithelial ovarian cancer and advanced ovarian cancer at the first diagnosis.Conclusion: Both serum CA125 and plasma D-dimer levels are significantly increased in patients with epithelial ovarian cancer recurrence.Plasma D-dimer can be used as a potential tumor marker,and the combination of the two can improve the detection efficiency and contribute to the early diagnosis of epithelial cancer recurrence.The diagnostic value of D-dimer is higher especially in older patients and the diagnostic value of CA125 is higher especially in advanced and high-grade epithelial ovarian cancer.