Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (7): 104-109.doi: 10.6040/j.issn.1671-7554.0.2021.0819

Previous Articles     Next Articles

Ultrasound characteristics and preoperative CA-125 level in the differential diagnosis of 51 cases of borderline ovarian and stage I malignant tumors

ZHANG Yixin, ZHAO Yuli, FENG Li   

  1. Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Abdominal Medical Imaging, Jinan 250014, Shandong, China
  • Published:2022-07-27

PDF (PC)

51

Abstract: Objective To investigate the value of ultrasound characteristics combined with preoperative serum carbohydrate antigen 125(CA-125)levels in the differential diagnosis of borderline ovarian tumors(BOTs)and stage Ⅰ epithelial ovarian cancer(EOC). Methods Clinical data of 27 EOC and 24 BOT pathologically confirmed cases treated during June 2019 and June 2020 were retrospectively analyzed. Independent factors related to ovarian invasion, including clinical variables(menstrual status), ultrasound characteristics and CA-125 level, were analyzed with multivariate binary Logistic regression with stepwise selection of variables. Results Ultrasound findings showed masses with rough edges, ascites, and rich blood flow(blood flow score=4)were indicative of stage Ⅰ EOC, while papillary protrusions and partitions were present in BOT. The ratio of preoperative CA-125 >35 IU/mL or >100 IU/mL in stage Ⅰ EOC was much higher than that in BOT(81.5 vs 41.7%, P=0.003; 40.7 vs 8.3%, P=0.008). The sensitivity and specificity of serum CA-125 level for distinguishing BOT and stage Ⅰ EOC were 81.5% and 58.3%, respectively, indicating that CA-125 level had a certain diagnostic reference value. Multivariate Logistic regression showed that CA-125>100 IU/mL was a key independent factor distinguishing BOT from stage Ⅰ EOC, indicating that patients with CA-125 >100 IU/mL had almost 14.67 times greater likelihood of stage Ⅰ EOC compared patients with CA-125 ≤100 IU/mL(OR=14.67; 95%CI: 1.32-162.94; P=0.029). Conclusion Preoperative CA-125 >100 IU mL combined with ultrasound characteristics helps in the differential diagnosis of borderline ovarian tumor and stage Ⅰ epithelial ovarian cancer before surgery.

Key words: Borderline ovarian tumors, Epithelial ovarian carcinoma, Carbohydrate antigen 125, Ultrasound, Adnexal

CLC Number: 

  • R445.1
[1] Hauptmann S, Friedrich K, Redline R, et al. Ovarian borderline tumors in the 2014 WHO classification: evolving concepts and diagnostic criteria [J]. Virchows Arch, 2017, 470(2): 125-142.
[2] Taylor HC. Malignant and semimalignant tumors of the ovary [J]. Surg Gynecol Obstet, 1929, 48: 204-230.
[3] Gershenson DM. Management of borderline ovarian tumours [J]. Best Pract Res Clin Obstet Gynaecol, 2017, 41: 49-59. doi: 10.1016/j.bpobgyn.2016.09.012.
[4] Manchul LA, Simm J, Levin W, et al. Borderline epithelial ovarian tumors: a review of 81 cases with an assessment of the impact of treatment [J]. Int J Radiat Oncol Biol Phys, 1992, 22(5): 867-874.
[5] Lee EJ, Kim SH, Kim YH, et al. Is CA-125 an additional help to radiologic findings for differentiation borderline ovarian tumor from stage I carcinoma? [J]. Acta Radiol, 2011, 52(4): 458-462.
[6] Rosen DG, Wang L, Atkinson JN, et al. Potential markers that complement expression of CA125 in epithelial ovarian cancer [J]. Gynecol Oncol, 2005, 99(2): 267-277.
[7] Xu Y, Zhong R, He J, et al. Modification of cut-off values for HE4, CA125 and the ROMA algorithm for early-stage epithelial ovarian cancer detection: results from 1 021 cases in South China [J]. Clin Biochem, 2016, 49(1-2): 32-40.
[8] Araujo KG, Jales RM, Pereira PN, et al. Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center [J]. Ultrasound Obstet Gynecol, 2017, 49(6): 778-783.
[9] Webb PM, Jordan SJ. Epidemiology of epithelial ovarian cancer [J]. Best Pract Res Clin Obstet Gynaecol, 2017, 41: 3-14. doi: 10.1016/j.bpobgyn.2016.08.006.
[10] Moufarrij S, Dandapani M, Arthofer E, et al. Epigenetic therapy for ovarian cancer: promise and progress [J]. Clin Epigenetics, 2019, 11(1): 7.
[11] Campbell S, Gentry-Maharaj A. The role of transvaginal ultrasound in screening for ovarian cancer [J]. Climacteric, 2018, 21(3): 221-226.
[12] 漆玖玲, 陆蓓蕾, 樊韵玲,等. 卵巢浆液性交界性肿瘤与卵巢浆液性囊腺瘤超声特征对比分析. [J]. 中国超声医学杂志, 2020, 36(10): 934-937.
[13] Bourdel N, Huchon C, Abdel Wahab C, et al. Borderline ovarian tumors: guidelines from the French national college of obstetricians and gynecologists(CNGOF)[J]. Eur J Obstet Gynecol Reprod Biol, 2021, 256: 492-501. doi: 10.1016/j.ejogrb.2020.11.045.
[14] 王士琴, 袁伟, 赵进娥. 经阴道超声对卵巢肿瘤的诊断与鉴别诊断的应用价值[J]. 影像研究与医学应用, 2020, 4(15): 154-156.
[15] 杨孝明,李玉宏. 妇科恶性肿瘤保留生育功能的诊治 [J]. 中国优生与遗传杂志, 2021, 29(2): 139-142. YANG Xiaoming, LI Yuhong. Fertility preservation for patients with gynecologic malignancies [J]. Chinese Journal of Birth Health & Heredity, 2021, 29(2): 139-142.
[16] Darai E, Fauvet R, Uzan C, et al. Fertility and borderline ovarian tumor: a systematic review of conservative management, risk of recurrence and alternative options [J]. Hum Reprod Update, 2013, 19(2): 151-166.
[17] Timor-Tritsch IE, Foley CE, Brandon C. New sonographic marker of borderline ovarian tumor: microcystic pattern of papillae and solid components [J]. Ultrasound Obstet Gynecol, 2019, 54(3): 395-402.
[18] Bent CL, Sahdev A, Rockall AG, et al. MRI appearances of borderline ovarian tumours [J]. Clin Radiol, 2009, 64(4): 430-438.
[19] Pascual MA, Tresserra F, Grases PJ, et al. Borderline cystic tumors of the ovary: gray-scale and color Doppler sonographic findings [J]. J Clin Ultrasound, 2002, 30(2): 76-82.
[20] Dochez V, Caillon H, Vaucel E, et al. Biomarkers and algorithms for diagnosis of ovarian cancer: CA125, HE4, RMI and ROMA, a review [J]. J Ovarian Res, 2019, 12(1): 28.
[21] Valentin L, Jurkovic D, Van Calster B, et al. Adding a single CA 125 measurement to ultrasound imaging performed by an experienced examiner does not improve preoperative discrimination between benign and malignant adnexal masses [J]. Ultrasound Obstet Gynecol, 2009, 34(3): 345-354.
[22] deSouza NM, ONeill R, McIndoe GA, et al. Borderline tumors of the ovary: CT and MRI features and tumor markers in differentiation from stage I disease [J]. AJR Am J Roentgenol, 2005, 184(3): 999-1003.
[23] Van Calster B, Timmerman D, Bourne T, et al. Discrimination between benign and malignant adnexal masses by specialist ultrasound examination versus serum CA-125 [J]. J Natl Cancer Inst, 2007, 99(22): 1706-1714.
[24] 段丽, 李菊香, 王亚敏,等. 经阴道超声、MSCT联合血清CA125、CA724诊断卵巢肿瘤的应用价值探讨[J]. 中国CT和MRI杂志, 2021, 19(6): 128-130. DUAN Li, LI Juxiang, WANG Yamin, et al. Application value of transvaginal ultrasound and MSCT conbined with serum CA125 and CA724 in diagnosis of ovarian tumors [J]. Chinese Journal of CT and MRI, 2021, 19(6): 128-130.
[25] 王建伟, 谢海花, 孙嘉峰,等. 血清癌胚抗原人附睾蛋白4 糖类抗原125糖类抗原199单独和联合检测在卵巢癌中的诊断价值[J]. 实用医技杂志, 2021, 28(6): 723-725. WANG Jianwei, XIE Haihua, SUN Jiafeng, et al. The diagnostic value of serum carcinoembryonic antigen,human epididymal protein 4,carbohydrate antigen 125,carbohydrate antigen 199 alone and four combined tests in ovarian cancer [J]. Journal of Practical Medical Techniques, 2021, 28(6): 723-725.
[1] TAO Guowei, WANG Fang, DONG Xiangyi, XU Yaxuan, ZHAO Linli, HU Beibei. Diagnosis of adenomyosis using ultrasound and magnetic resonance imaging [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 56-65.
[2] AILI Aixingzi, GUO Zhengyu, ZHANG Xiaofei. Latest research advances of high intensity focused ultrasound treatment for adenomyosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 36-42.
[3] REN Dazhuang, ZHOU Weiyan, ZHAO Bojun. A case report of corneoscleral iron filing-like foreign body [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 129-132.
[4] DONG Liang, CUI Wenchao, ZHOU Qing, ZHANG Longyun, ZHOU Wei, ZHANG Xin, ZHAO Chao. Comparison of ultrasound and enhanced CT percutaneous puncture of mixed density chest lesions [J]. Journal of Shandong University (Health Sciences), 2022, 60(5): 98-103.
[5] XIA Shujie, GUAN Yanjie. Progress on the activation of endogenous stem cells and functional repair in LIPUS mechanotransduction [J]. Journal of Shandong University (Health Sciences), 2021, 59(9): 37-42.
[6] WANG Yixuan, LI Fei, HU Rong, WANG Bei. Value of ovarian-adnexal reporting and data system in differentiating 101 benign and malignant ovarian-adnexal masses [J]. Journal of Shandong University (Health Sciences), 2021, 59(4): 87-92.
[7] LI Ning, WANG Cuilan, ZHANG Yurong. Association analysis of cerebral artery Doppler index and serum EGF level with arteriosclerosis and cognitive impairment in 60 patients with Parkinsons disease [J]. Journal of Shandong University (Health Sciences), 2021, 59(3): 61-66.
[8] WU Mengtao, WU Peng, YANG Yanfei, TANG Dianjun, MIAO Xiangling, LI Fandong. Application of CT venography in the diagnosis and treatment of recurrent lower extremity varicose veins [J]. Journal of Shandong University (Health Sciences), 2020, 1(9): 21-26.
[9] GUAN Yanfei, CHEN Zhiqiang, YUAN Chunlei, PENG Jianming, MI Xianjun, LIU Jun, CHEN Ang, YUAN Bin, LIU Zicheng. Detection of tumor cells, carbohydrate antigen 153, carbohydrate antigen 125 and carcinoembryonic antigen in peripheral blood circulation in 105 cases of ductal carcinoma in situ or with minimal invasive carcinoma [J]. Journal of Shandong University (Health Sciences), 2020, 58(2): 72-78.
[10] SUN Yongfeng, LIU Huizhao, LI Yuhuan, SHI Lei, YUAN Jun, ZHONG Jianwei. Application of ultrasound-guided electrocorticography monitoring in the microsurgical treatment of epilepsy secondary to cerebral arteriovenous malformation [J]. Journal of Shandong University (Health Sciences), 2020, 58(12): 60-64.
[11] LU Jingjing, XIA Yu. Imaging diagnosis of endometriosis [J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 40-45.
[12] CHEN Xi, LIU Xinyu, FAN Lixia, TIAN Yonghao, YUAN Suomao. Clinical value of carotid ultrasound in evaluating ischemic stroke risk in elderly patients with spinal diseases [J]. Journal of Shandong University (Health Sciences), 2019, 57(5): 48-55.
[13] LÜ Jiaju, HU Jialin, DING Sentai. Advances in focal therapy for prostate cancer [J]. Journal of Shandong University (Health Sciences), 2019, 57(1): 1-5.
[14] YUAN Peng, LI Ya, ZHANG Feixue, WANG Qing. Clinical value of lung ultrasound in the diagnosis of neonatal infectious pneumonia [J]. Journal of Shandong University (Health Sciences), 2018, 56(6): 29-34.
[15] LI Liang, GE Na, SUN Xiao, LI Jie, ZHU Jiang, LI Zhongliang. Value of VTQ and VTIQ on differentation of benign and malignant breast masses [J]. Journal of Shandong University (Health Sciences), 2018, 56(4): 70-75.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] SUO Dongyang, SHEN Fei, GUO Hao, LIU Lichang, YANG Huimin, YANG Xiangdong. Expression and mechanism of Tim-3 in animal model of drug-induced acute kidney injury[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 1 -6 .
[2] MA Qingyuan, PU Peidong, HAN Fei, WANG Chao, ZHU Zhoujun, WANG Weishan, SHI Chenhui. Effect of miR-27b-3p regulating SMAD1 on osteosarcoma cell proliferation, migration and invasion[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 32 -37 .
[3] XU Yuxiang, LIU Yudong, ZHANG Peng, DUAN Ruisheng. A retrospective analysis of risk factors of cerebral microbleeds in 101 patients with cerebral small vessel disease[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 67 -71 .
[4] ZHANG Baowen, LEI Xiangli, LI Jinna, LUO Xiangjun, ZOU Rong. miR-21-5p targeted TIMP3 to inhibit proliferation and extracellular matrix accumulation of mesangial cells in Type II diabetic nephropathy mice[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 7 -14 .
[5] FU Jieqi, ZHANG Man, ZHANG Xiaolu, LI Hui, CHEN Hong. Molecular mechanism of Toll-like receptor 4 in the aggravation of blood lipid accumulation by inhibiting the peroxisome proliferator-activate receptor γ[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 24 -31 .
[6] DING Xiangyun, YU Qingmei, ZHANG Wenfang, ZHUANG Yuan, HAO Jing. Correlation of the expression of insulin-like growth factor II in granulosa cells and ovulation induction outcomes of 84 patients with polycystic ovary syndrome[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 60 -66 .
[7] LONG Tingting, XIE Ming, ZHOU Lu, ZHU Junde. Effect of Noggin protein on learning and memory abilities and the dentate gyrus structure after cerebral ischemia reperfusion injury in mice[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 15 -23 .
[8] LI Ning, LI Juan, XIE Yan, LI Peilong, WANG Yunshan, DU Lutao, WANG Chuanxin. Expression of LncRNA AL109955.1 in 80 cases of colorectal cancer and its effect on cell proliferation, migration and invasion[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 38 -46 .
[9] XIAO Juan, XIAO Qiang, CONG Wei, LI Ting, DING Shouluan, ZHANG Yuan, SHAO Chunchun, WU Mei, LIU Jianing, JIA Hongying. Comparison of diagnostic efficacy of two kinds of thyroid imagine reporting and data systems[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 53 -59 .
[10] GUO Zhihua, ZHAO Daqing, XING Yuan, WANG Wei, LIANG Leping, YANG Jing, ZHAO Qianqian. Single-stage end-to-end anastomosis in the management of severe cervical tracheal stenosis[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 72 -76 .
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd