The clinical diagnosis of ovarian cancer 1. Clinical manifestations occur in perimenopausal women, in the early stage without any symptoms.
(1) ovarian cancer, the main symptoms: early stage ovarian cancer can be asymptomatic. Lower abdomen discomfort, bulge or pain, abdominal lump in the abdomen in advanced ovarian cancer as the main clinical manifestations. Less common persistent abdominal pain, bulging, with the growth of the tumor mass can reach the lower abdomen and take root, often the pelvic or abdominal internal organs of metastasis. May be associated with poor appetite, nausea and weight loss and other symptoms.
(2) and severe symptoms of disease or
irregular menstruation: see menstrual cycle and after blood disorders, see the irregular uterine bleeding and late postmenopausal bleeding. Disorders caused due to sex hormones.
ascites: Ovarian cancer often abdominal or pelvic metastasis occurs, causing ascites, abdominal big as a drum. Large amount of ascites, increased intra-abdominal pressure, can cause cross-chest raise and blood disorder caused by shortness of breath and difficulty returning lying, palpitation shortness of breath and lower extremity edema.
dysuria or urinary urgency: advanced ovarian cancer, tumor growth rapidly and oppression around the organs, resulting in stimulation of voiding difficulties or urinary tract symptoms.
obstruction: tumor invasion or compression of intestinal wall, can cause intestinal obstruction, there induration or unreasonable stool, abdominal cramps.
cachexia: advanced ovarian cancer by eating well, and tumor growth consumes a lot of protein, there may be progressive weight loss, anemia, cachexia performance.
distant metastasis: ovarian cancer than abdominal pelvic metastasis occurs, it can also occur distant organs or lymph node metastasis, such as liver metastasis, lung metastasis, bone metastases and supraclavicular lymph node metastasis, can produce the corresponding clinical manifestations.
Clinical diagnosis of ovarian cancer 2. Diagnosis of ovarian cancer early can be no significant clinical manifestations, often occurs in women between 40-60 years of age. Before and after the menopause clinic, there unexplained gastrointestinal symptoms, weight loss, abdominal pain or discomfort, abdominal mass, irregular vaginal bleeding, should pay attention to. Physical examination, irregular pelvic mass reach, in solid or cystic, and relatively fixed, the possibility should be suspected ovarian cancer should be further check the following:
(1) cytology: illness can be combined with checks drawn in different ways. Common methods are:
suction posterior fornix smears: the positive rate was 33%, check the convenient, repeatable, no damage, such as to get rid of the uterus, fallopian tube cancer, ovarian cancer diagnosis can be one of the indicators.
puncture and aspiration of uterine fluid or rectal fossa fluid examination: no inflammation, adhesions, scar stasis may be.
ascites check: can through the abdominal wall or posterior fornix puncture fluid, ascites volume of 200ml submission to take the cancer detection rate of up to 93%. In case of mesothelial cells, red sand body or mucus card positive cells, is also characteristic of malignant tumors.
purified ascites cytology: use of 20Pm mesh nylon filters, filtered ascites in a single cell and small cell, large cell specimens from the block, by immunocytochemistry analysis, cells positive rate of 90.6% 1.7% – 97.5 0.5%.
histological examination: tumor close to the abdominal wall or vaginal fornix before or after those used fine needle aspiration cytology of tumor tissue fluids or tissues for pathological examination, diagnostic accuracy rate of 85% -90%.
(2) tumor marker examination
determination of carbohydrate antigen CA ~ 125: normal reference values of CA ~ 125 <3.4 u / L. Radioimmunoassay in serum of ovarian cancer positive rate of 80% when the clinical compliance rate of 90%. Decompensated liver cirrhosis by serum CA ~ 125 also significantly increased.
human chorionic gonadotropin (hCG) determination: normal reference values in human serum hCG <10glL, urinary hCG <30 / ~ lgl L. In pregnant and non-time gestational trophoblastic tumor increased when the primary ovarian choriocarcinoma is also increased. Now pay more attention to the serum white: ~ hCG test, to avoid cross-LH.
carcinoembryonic antigen (CEA) measurement: different testing method, normal human serum CEA reference value <5g/L15g/LoCEA not a specific marker of ovarian cancer, mainly gastrointestinal cancer marker. When ovarian cancer serum positive rate of about 42% -48%, respectively.
Comprehensive analysis of these tests shall be alone one kind of immunoassay, to determine whether a treatment is hard to be a malignant ovarian tumor.
(3) imaging: such as B-, CT, MRl Although the internal structure of the tumor can be as accurate, but because of cystic, solid or both may be in the presence of various ovarian tumors, and contains organizational complexity, but also tend to make the image a lack of specificity, and thus should be combined with other tests, can only qualitative. Single expansion t131 I ~ CEA, 99mTC ~ CEA, 131 lCOCl82 B2 radioimmunoimaging diagnosis will play a role in this regard.
The clinical diagnosis of ovarian cancer (4) endocrine examination: primary ovarian choriocarcinoma can be caused by hyperthyroidism, thyroid hormone secretion, and some ovarian serous cystadenoma, dysgerminoma can secrete membrane caused by continuous insulin hypoglycemia, Such situation is very rare.