The diagnosis of ovarian cancer, for ovarian cancer, especially early ovarian cancer, the current lack of specific and sensitive diagnostic method. Check the following means of integrated applications to help improve the preoperative diagnosis rate.
1. Imaging studies
(1) X-ray chest examination can help to detect pleural effusion; abdominal plain film shows calcifications within the cystic teratoma; gastrointestinal Dayton rent lock enema meal helps eliminate primary tumors of the gastrointestinal tract and understanding of the gastrointestinal tract There yuan involvement; urinary tract imaging bladder and ureter realizable pressure or violations.
(2) B-type ultrasonic inspection can be found Gynecological Examining the ovaries can not clear a small palpable mass; can distinguish solid and cystic tumor and the capsule with or without the nipple, which helps determine the benign and malignant tumors; to explore and ascites and abdominal lesions larger basin, especially the liver, spleen and kidney and other organ metastases diagnosis of substantial help. Ultra-high resolution transvaginal B, and distorted vaginal probe closer to the pelvic organs can be more clearly observe the size and shape of the ovary.
(3) computed tomography (CT) and magnetic resonance Photography (MRD: Super can be detected in B minor illness difficult to find the spit, and high resolution, it is high accuracy. In addition, CT and MRI can clearly show the tumor and surrounding tissue the relationship between organs and abdominal pelvic lymph nodes, as well as liver and spleen and other organs have real per transfer, diagnosis, staging more drugs to help.
(4), positron emission tomography (PET / CT): is the most advanced imaging tools. Commonly used imaging agent 18F labeled deoxyglucose (l8F-FDG), a relatively long half-life may reflect the organization of the sugar on behalf of the channeling. Tumor tissue of 18FDG strong metabolism, tumor uptake of FDG is much higher than normal tissue and benign types of tumors. General clinical imaging width of the size of tumor lesions were detected value is lcm3 (109 cells), PET may be found in smaller lesions.
2. Tumor markers
Ovarian cancer a wide range, not each have their corresponding tumor markers, tumor markers currently known specificity are not high, must be combined with other test results to make a diagnosis.
(1) alpha-fetoprotein (AFP): In malignant ovarian germ cell tumors, such as endodermal sinus tumor and embryonal carcinoma wow, there may be positive, but should be excluded from primary liver cancer, hepatitis and AFP baby positive vibration, etc., there may be circumstances was measured after treatment may also be an indicator of disease surveillance.
(2) R subunit of human chorionic gonadotropin. -HCG): {3-HCG is a component of ovarian choriocarcinoma with a small fall of reproductive tumors, such as embryonal carcinoma and primary choriocarcinoma of the sensitive tumor marker.
(3) CA125 determination: CA125 is the ovarian cancer associated antigen. Other benign mullerian derivatives, such as lodging, endometriosis of the peritoneum inflammation and may also appear positive. Specificity of this marker is not very strong, but the sensitivity of high wind, the positive rate of epithelial ovarian cancer up to 82% _94%. Is currently the most widely used clinical marker for ovarian cancer.
In addition, the sex cord stromal tumors and a number of epithelial ovarian tumors intoxicated serum estradiol and progesterone levels can be increased; some of the main reproductive cell tumors and epithelial tumors of the carcinoembryonic antigen (CEA) increased; CA199 detection of cancer and in liquid cancer have a higher weight transparent fine sensitivity, the determination of these markers can be used as diagnostic reference.
The diagnosis of ovarian cancer, 3. Lord cytology
Primarily for ascites cytology. Exudative ascites fluid of ovarian cancer, and more can be found in cancer cells, inspection of the love of the high preoperative diagnosis of ovarian cancer is essential. Laparoscopic Laparoscopy also help early diagnosis of ovarian cancer. When Gynecological Examining and B-ultrasound examination or blood CA125 to block suspected ovarian cancer, a large number of difficult and tuberculosis ascites, cirrhosis and other identification, confirmed by laparoscopy. Also contribute to ovarian cancer, primary or metastatic things Identification and proper staging of ovarian cancer.