What is the basis for differential diagnosis of ovarian cancer

Ovarian cancer is a malignant tumor with a short course. The tumor grows relatively fast, has poor mobility, is hard in texture, and has an uneven surface with cracks. After triple examination, papillary nodules can be felt in the tumor, and it is often accompanied by edema of the whole body or lower limbs, cachexia, bloody abdomen, etc. Many women start to have wild thoughts when they have these symptoms. They don't know how to make a differential diagnosis of ovarian cancer. So what is the basis for differential diagnosis of ovarian cancer?

(I) Early diagnosis Since there are no typical symptoms and signs in the early stage of ovarian malignant tumors, it is still extremely important to inquire about the medical history in detail and to conduct a careful physical and gynecological examination. If there is any suspicious situation in the clinic, it should be diagnosed as soon as possible with the help of modern imaging examinations and broad tumor marker examinations. The so-called suspicious situation may be long-term ovarian dysfunction, long-term unexplained digestive or urinary tract symptoms, enlarged ovaries in young girls or palpable ovaries after menopause, and rapid enlargement, fixation, and hardening of suspected ovarian tumors.

(II) Positional diagnosis: For patients who can feel the adnexal mass in the early stage, combined with imaging examination, the positional diagnosis is not difficult. However, in some cases, the primary tumor metastasizes outside the ovary and forms scattered small nodules in the pelvic cavity when it is still young. At this time, some special examination methods should be selected for auxiliary diagnosis (qualitative diagnosis), and should not rely solely on follow-up and make mistakes.

(III) Qualitative diagnosis Although diagnostic techniques are changing with each passing day, vaginal fornix aspiration smear examination, uterine rectal pouch puncture fluid examination and ascites cytology examination are still simple, easy and fast basic examinations. For suspicious cases, laparoscopy and histological examination can immediately confirm the diagnosis. Imaging examinations, especially vaginal ultrasound scanning, can help to make a qualitative diagnosis of the boundaries (involved range) and internal structure (nature) of early ovarian malignant tumors. Endocrine examinations are helpful in the diagnosis of ovarian gonadal stromal tumors and some ovarian cancers with ectopic endocrine syndrome. The detection of serum tumor markers such as CA125, CEA, SONA, SGA, etc. is highly sensitive to ovarian malignant tumors, but its specificity is poor, so its type cannot be determined by a single immunological test. However, the combined detection of multiple tumor markers, such as the simultaneous detection of CA125, CEA, ferritin and tissue polypeptide antigen (TPA), can improve the reliability of qualitative diagnosis.