Value Of Contrast-enhanced Ultrasound Combined With Serum CA125 In The Diagnosis Of Benign And Malignant Ovarian Epithelial Tumors

Objective: The parameters of benign and malignant ovarian epithelial tumors were analyzed by contrast-enhanced ultrasound.To investigate the value of the combination of contrast-enhanced ultrasound(CEUS)and carbohydrate antigen 125(CA125)in differentiating benign and malignant epithelial ovarian tumors(EOTs).Methods: A total of 57 patients with epithelial ovarian tumors diagnosed by postoperative pathology in Changzhou Second People’s Hospital from June 2020 to April 2022 were selected.All patients underwent contrast-enhanced ultrasound examination and serum CA125 detection before operation,and the clinical data were complete.When performing contrast-enhanced ultrasound,the boundary,shape and internal echo of the mass were firstly observed,and then the target lesions were selected for quantitative analysis using Q-Lab software to obtain the rise time(RT),rise slope(WIS),peak intensity(PI),time to peak(TTP),area under the curve(AUC).To compare the characteristics of contrast-enhanced ultrasound(CEUS)in benign and malignant epithelial ovarian tumors.The sensitivity,specificity,positive predictive value and negative predictive value of contrast-enhanced ultrasound,serum CA125 detection alone and CEUS combined with serum CA125 in differential diagnosis of benign and malignant epithelial ovarian tumors were calculated.To compare the diagnostic effectiveness of different diagnostic methods.Results:(1)Among the 57 patients confirmed by surgery and pathology,there were 20 cases of malignant epithelial ovarian tumors and 37 cases of benign epithelial ovarian tumors.(2)Serum CA125 expression level of patients: Serum CA125 expression levels in malignant and benign ovarian epithelial tumors were 76.2(20.6,115.3)U/m L and17.9(8.1-41.6)U/m L,respectively.The expression level of CA125 in the malignant group was significantly higher than that in the benign group(p = 0.002).(3)In contrastenhanced ultrasound,the qualitative parameters of malignant epithelial ovarian tumors showed solid mass with irregular shape,nonhomegeneous enhancement pattern and internal echo,the boundary is not clear.The qualitative parameters of benign ovarian epithelial tumors are cystic or solid masses with regular shape,homogeneous enhancement pattern,and there was no internal echo,the boundary is clear(p<0.0001).The quantitative parameters of malignant and benign ovarian epithelial tumors showed that RT was 11.2±4.9(6.5-25.1)s,21.3±5.4(6.8-37.0)s,TTP was 29.8±7.9(16.01-50.6)s,42.1±18.6(11.5-100.1)s,respectively.RT and TTP in the malignant group were significantly shorter than those in the benign group(p < 0.0001,p= 0.007).The AS,and of malignant and benign ovarian epithelial tumors were 2.1(1.6,4.4),1.1(0.8,1.7),PI was 25.4(19.3,52.9)d B/s,11.8(10.6,18.6)d B/s,and AUC was 1855.7±1254.9(567.3-5899.1),670.8±399.2(105.3-1541.8),respectively.AS,PI and AUC in the malignant group were significantly higher than those in the benign group(p =0.001,p < 0.0001,p < 0.0001).(3)The sensitivity of CEUS in the differential diagnosis of malignant and benign ovarian epithelial tumors was 80.0%,the specificity was 86.5%,the positive predictive value was 76.2% and the negative predictive value was 88.9%,respectively.The sensitivity of serum CA125 in differential diagnosis of malignant and benign ovarian epithelial tumors was 70.0%,the specificity was 62.2%,the positive predictive value was 50.0% and the negative predictive value was 79.3%,respectively.In addition,the sensitivity and specificity of CEUS combined with serum CA125 in the differential diagnosis of malignant and benign ovarian epithelial tumors were 90.0% and 94.6%,respectively,which were significantly higher than those of CEUS and serum CA125 alone.The difference was statistically significant(X2= 8.889,5.185,p = 0.003,0.023)(X2 = 13.531,4.405,p = 0.000,0.036).The positive predictive value and negative predictive value of CA125 combined with CEUS in the differential diagnosis of malignant and benign epithelial ovarian tumors were 90.0% and94.6%,respectively,which were also significantly higher than those of CA125 alone(X2=7.619,4.163,p = 0.006,0.041).There was no significant difference between CEUS combined with CA125 and CEUS(X2=1.558,0.725,p = 0.212,0.394).(5)The area under the curve(AUC)of CEUS combined with CA125 in the diagnosis of benign and malignant epithelial ovarian tumors was 0.923,p < 0.001;the AUC of serum CA125 was 0.760,p = 0.001;the AUC of CEUS diagnosis was 0.832,p < 0.001;the AUC of combination was greater than for each individual diagnosis.Conclusion: Malignant and benign ovarian epithelial tumors have different CEUS parameters.Contrast-enhanced ultrasound combined with serum CA125 has a good diagnostic performance in differential diagnosis of benign and malignant epithelial ovarian tumors.