The Value Of Serum CA125 Combined With RBP4 In The Differential Diagnosis Of GI-RADS4 Adnexal Masses

Part one Application Value of Different GI-RADS Classification Methods in Differential Diagnosis of Benign and Mmalignant Adnexal MassesObjective:To explore the application value of GI-RADS(Gynecologic Imaging Reporting and Data System)classification method in differentiating benign and malignant adnexal masses,compare different methods,and obtain the best criteria for judging benign and malignant adnexal masses.Methods:From January 2019 to may 2020,200 cases of adnexal masses(adnexal masses)treated and examined by ultrasound in the Second Affiliated Hospital of Zhengzhou University were selected and classified by two ultrasound doctors according to GI-RADS classification system.GI-RADS1-3 was the benign predictor,4a,4b and 5were the malignant predictors,which were recorded as GR1;GI-RADS1-4a was the benign predictor,4b and 5 were the malignant predictors,which was recorded as GR2;GI-RADS1-4b was the benign predictor,GI-RADS 5 were the malignant predictors,which was recorded as GR3.The postoperative pathological diagnosis results(gold standard)were compared,Part of the masses with high possibility of benign lesions were not punctured and pathologically obtained.Complete ultrasound data of 3-6months were available.The disappearance or no change of the lesions was defined as benign lesions for analysis.and the application value of three criteria for judging the benign and malignant adnexal masses was calculated and statistically analyzed.Results:The sensitivity of GR1 、 GR2 、 GR3 was 89.04%,72.60% and 39.73%respectively;the specificity was 70.07%,98.42% and 99.21% respectively;the positive predictive value was 63.10%,96.36% and 96.67% respectively;the negative predictive value was 91.75%,86.21% and 74.12% respectively;the diagnostic coincidence rate was 77%,89% and 77.5% respectively;the correct diagnostic index was 0.59,0.71 and 0.39 respectively.Conclusion:GI-RADS has good application value in the prediction of benign and malignant adnexal masses,and GR2 has the best effect.Part two The Value of Serum CA125 Combined with RBP4 in the Differential Diagnosis of GI-RADS4 Adnexal MassesObjective:To investigate the value of serum CA125(Carbohydrate Antigen 125)combined with RBP4(Human Retinol Binding Protein 4)in the differential diagnosis of benign and malignant adnexal masses of gi-rads4.Methods:From January 2019 to may 2020,the adnexal masses treated and examined by ultrasound in the Second Affiliated Hospital of Zhengzhou University were retrospectively analyzed.According to the GI-RADSs classification system,two ultrasound doctors classified the adnexal masses into four categories,including 73 cases,48 cases of 4a(defined as benign),and 2 cases of 4b 5 cases(defined as malignant).All patients were examined for serum CA125 and RBP4 levels before operation,and pathological results were obtained by operation or puncture.According to the results of serological examination,the four types of masses were upgraded and degraded,and the benign and malignant adnexal masses were preliminarily diagnosed.The pathological diagnosis results were taken as the gold standard for statistical analysis.The application value of CA125 alone,RBP4 alone and their combination(CA125 or RBP4,CA125 and RBP4)in the differential diagnosis of benign and malignant adnexal masses were calculated,and the best combination was obtained Methods the application value of improved gi-rads classification method in the differential diagnosis of benign and malignant masses was calculated and compared with the application value of serology in the diagnosis of benign and malignant masses.Results:1.The pathological results of 4 types of masses included in the study were: 36 cases of malignant tumors(including 6 cases of borderline tumors),37 cases of benign tumors.There were significant differences in serum CA125 and RBP4 concentrations between benign and malignant lesions(P < 0.05).2.38cases(28 cases of pathological malignancy,10 cases of benign)had positive serum CA125,and 35 cases(8 cases of pathological malignancy,27 cases of positive)had normal serum CA125.Serum RBP was positive in 39 patients(31 pathologically malignant and 8 benign),and RBP4 was normal in 34 patients(5 pathologically malignant and 29 benign).The coincidence rate of CA125 alone in the diagnosis of benign and malignant masses was 75.34%,and Youden index(YI):0.51.The coincidence rate of RBP4 alone in the diagnosis of benign and malignant masses was82.19%,and the Youden index(YI): 0.64.3.When one of CA125 and RBP4 was positive,the mass was upgraded to category 5.A total of 46 cases were initially diagnosed as malignant(31 cases were both positive,7 cases were CA125 positive and RBP4 negative,8 cases were RBP4 positive and CA125 negative),31 cases were both negative and initially diagnosed as benign.The application value of CA125,RBP4 and their combination in the differential diagnosis of benign and malignant adnexal masses was compared.Serum CA125 combined with RBP4 for gi-rads4 adnexal masses were graded up and down.The diagnostic coincidence rate of benign and malignant adnexal masses was 80.82%,and the Youden index(YI): 0.62.4.When both CA125 and RBP4 were positive,the mass was upgraded to 5categories,and 31 cases were initially diagnosed as malignant.When one of them was negative or both were negative,the mass was reduced to 3 categories,and 42 cases were initially diagnosed as benign(31 cases were both negative,7 cases were RBP4 negative and CA125 positive,8 cases were CA125 negative and RBP4positive).The application value of CA125,RBP4 and their combination in the differential diagnosis of benign and malignant adnexal masses was compared.The diagnostic coincidence rate of benign and malignant masses of 4 types was 76.71%,and the Youden index(YI)was 0.53.5.Improved gi-rads(four types of masses are divided into 4A and 4B: 4a is benign,4b is malignant)diagnostic coincidence rate of benign and malignant of four types of masses is 82.19%,Youden index(YI): 0.64.Conclusion:Serum CA125 and RBP4 have a good application value in differentiating benign adnexal masses from benign adnexal masses.The combination of RBP4 and CA125 alone has a better comprehensive effect.It can make a preliminary diagnosis of benign adnexal masses and improve the diagnostic efficiency of gi-rads classification system.It is a good supplementary method for early identification of malignant lesions,treatment,improvement of prognosis and clinical intervention In order to improve the survival rate and quality of life of patients.