The Clinical Value Of Preoperative CA125,HE4,CA153 And PCT In The Diagnosis Of Ovarian Tumors

Background:Ovarian cancer is one of the three most common gynecological tumors in female reproductive system malignancies.The ovaries are deep in the pelvic cavity.Ovarian malignant tumors usualy have no special clinical symptoms in the early stage.Due to the lack of specific symptoms and effective early diagnosis methods,it is usualy found accidentaly during gynecological examinations.Most patients are already at an advanced stage when they are diagnosed.For patients with metastases,radical surgery and chemotherapy have poor efficacy,which brings great difficulties to clinical diagnosis and treatment.In order to improve the quality of life and prognosis of patients,We need a more effective early screening system.Currently,clinical diagnosis of ovarian cancer mainly relies on gynecological pelvic examination,gynecological ultrasound,serum tumor markers,pelvic CT and MRI and other imaging examinations,but these methods stil have certain limitations and deficiencies in the diagnosis and treatment of early ovarian malignant tumors.The most ideal early diagnosis method for ovarian malignant tumors should have the characteristics of high sensitivity and specificity.In the conventional method of diagnosis,tumor markers have been widely used in the field of obstetrics and gynecology,and are recognized as a safe and effective diagnostic method.CA125 is the most commonly used ovarian tumor marker in clinical practice,but this indicator is widely used in ovarian cancer.Early sensitivity is low,and CA125 may also increase under certain physiological or pathological conditions.The early diagnosis and differential diagnosis of ovarian cancer have certain limitations only through CA125.It needs to be combined with other indicators or examinations to further clarify the nature of pelvic masses and provide strong support for the diagnosis and specific treatment of the disease.Human epididymal protein 4(Human epididymal protein 4,HE4)has received special attention in recent years.There are few studies on the relationship between carbohydrate antigen 153(CA153),Plateletcrit(PCT)and ovarian diagnosis.This article conducts related research on this.The purpose of this study is to explore the value of testing these indicators alone or in combination in the diagnosis of patients with ovarian tumors,and to provide evidence for the early diagnosis of patients.Purpose:The levels of CA125,HE4,CA153 and PCT in the blood of patients with ovarian benign and malignant tumors were compared,and the relationship between individual and combined detection in the differential diagnosis of abnormal benign tumors and the staging of ovarian malignant tumors was analyzed in order to improve the diagnostic efficiency.Methodology:The retrospective study included a total of 155 ovarian tumor patients who were hospitalized and received surgical treatment in the Second Hospital of Jilin University from January 2019 to December 2020.The clinical data was complete and all were pathologically diagnosed after operation,including 75 patients with ovarian cancer.80 patients with benign ovarian tumors.Check the patient’s preoperative serum CA125,HE4,CA153,PCT levels and related clinical data through medical records.Use SPSS25.0 software for statistical analysis.Results:1.The levels of CA125,HE4,CA153,and PCT in patients with ovarian malignant tumors are higher than those with benign ovarian tumors(P < 0.05);the levels of CA125,HE4,and CA153 in patients with ovarian malignant tumors of stage ⅲ-iv are higher than those of stage I-II(P < 0.05),in which the levels of CA125 and HE4 in patients with stage III-iv ovarian malignant tumors were significantly higher than those of stage I-II(P<0.001).2.The positive CA125,HE4,CA153 and PCT in the malignant ovarian tumor group are higher than the benign group(P < 0.05),and the combined detection indicators CA125 + HE4,CA153,CA125 + HE4 + CA153,CA125 + HE4 + CA153 are in the ovaries The positive rate of malignant tumor group was significantly higher than that of benign group(P<0.001);benign ovarian tumor group had a lower positive rate of independent detection and combined detection index,and the combined detection index of ovarian malignant tumor group was CA125+HE4,CA125+CA153,CA125+HE4 +CA153 positive rate is higher than single test.3.The positive rates of independent detection indexes CA125,HE4,CA153 in stage III-IV ovarian malignant tumor group were higher than those in stage I-II,and the difference was statistically significant(P<0.05).CA125 is in stage I-II and stage III-IV,and the positive rates of ovarian malignant tumor stage group are 77.8% and 97.4%,respectively.The positive rates of HE4 in stage I-II and stage III-IV of ovarian malignant tumors were 44.4% and 79.5%,respectively.CA153 is in phase I-II and III.-The positive rate of stage 4 ovarian malignant tumor group is lower.The positive rates of the combined detection indexes CA125+HE4,CA125+CA153,CA153+HE4 and CA125+HE4+CA153 in the stage Ⅰ-Ⅱ ovarian malignant tumor group were 77.8%,80.6%,50% and 80.6%,respectively.Stage Ⅲ-Ⅳ III-The positive rates of stage IV were 97.4%,97.4%,84.6% and 97.4%,respectively;the combined detection index of stage III-IV was higher than the single detection index.4.The levels of blood test indicators CA125,CA153,and HE4 in patients with ovarian malignant tumors were moderately positively correlated with the staging of ovarian malignant tumors(P<0.001);CA125,HE4,and CA153 were all significantly positively correlated(P < 0.001);HE4 and CA153 showed a significant positive correlation(P<0.001).5.The levels of CA125,HE4,and CA153 in epithelial and non-epithelial ovarian malignant tumor groups were significantly different(P < 0.05),and the detection indexes of the epithelial ovarian malignant tumor group were higher than those in the non-epithelial ovarian malignant tumor group Tumor group.6.In the benign ovarian tumor group,the levels of CA125 and HE4 were statistically different between the menopausal group and the non-menopausal group(P<0.05).The level of CA125 in the non-menopausal group was higher than that in the menopausal group,while HE4 was the opposite;the levels of PCT and CA153 were higher.The difference between the menopausal group and the non-menopausal group was not statistically significant(P>0.05);in the malignant ovarian tumor group,the level of HE4 was significantly different between the menopausal group and the nonmenopausal group(P<0.05),and the level of HE4 in the menopausal group Higher than the non-menopausal group;the levels of PCT,CA125,and CA153 were not statistically different between the menopausal group and the non-menopausal group(P>0.05).7.The best cut-off values (cut-off values)for PCT,CA125,HE4 and CA153 to distinguish benign and malignant ovarian tumors are 0.31%,50.45(U/m L),43.25(pmol/L),13.70(U/m L),respectively The sensitivity of diagnosing ovarian malignant tumors were 43.8%,80.8%,83.6%,and 68.5%;specificities were: 81.0%,96.2%,92.4%,89.9%;AUC values ??were 0.628,0.931,0.881,0.823,respectively.CA125,HE4,CA153 have higher accuracy rates in the differential diagnosis of ovarian benign and malignant tumors,while PCT has lower accuracy rates.The sensitivities of CA125+HE4,CA125+CA153,HE4+CA153,CA125+HE4+CA153 were 90.7%,81.3%,84.0%,85.3%,and the specificities were 88.8%,96.3%,92.5%,96.3%,respectively;AUC is 0.940,0.906,0.906 and 0.938,respectively.CA125+HE4,CA125+HE4+CA153have higher diagnostic accuracy.The sensitivity and specificity of combined detection for the differential diagnosis of ovarian benign and malignant tumors are generally higher than that of single detection,and the accuracy of diagnosis is also higher than that of single detection.8.The best cut-off values for detecting PCT,CA125,HE4,and CA153 to identify early and late stages of ovarian malignant tumors are 0.46%,455.70(U/m L),275.00(pmol/L),respectively.33.80(U/m L);the sensitivities for the diagnosis of advanced ovarian malignancies were 12.8,71.8%,51.3% and 64.1%,respectively;among them,the PCT level was not statistically significant in determining the early and late stages of ovarian malignancies(P>0.05).The sensitivities of CA125+HE4,CA125+CA153,HE4+CA153,CA125+HE4+CA153 were 74.4%,61.5%,74.4%,and69.2%,respectively,and the specificities were 75%,88.9%,63.6%,and 83.3%,respectively;Except for CA125+CA153,the sensitivity of the combined detection index is higher than that of the single detection index.In general,combined testing has higher clinical value in judging the staging of ovarian malignant tumors than individual testing of various indicators.Conclusions:1.The levels of indicators PCT,CA125,HE4,CA153 are related to the nature of ovarian tumors;2.The levels of indicators CA125,HE4,CA153 are related to the staging of ovarian malignant tumors;3.Ovarian benign tumor groups HE4,CA153 Not expressed;4.Combined detection indicators are more valuable than single detection indicators in the differential diagnosis of ovarian benign and malignant tumors.CA125+HE4 and CA125+HE4 +CA153 have better differential diagnosis efficiency;5.In ovarian malignancies,the active combined detection rate index is generally higher than the single detection index and the sensitivity index of comprehensive detection is higher than the single detection index in distinguishing early and late ovarian malignancies,indicating that the combined detection index is in the diagnosis of ovarian malignancies.Staging is more clinically meaningful.