Diagnosis of Ovarian Cancer

The diagnosis of ovarian cancer includes the following:

1. Early diagnosis

Since there are no typical symptoms and signs in the early stage of ovarian cancer, 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 early 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.

2. Positioning diagnosis

For patients who can feel the adnexal mass at an early stage, it is not difficult to make a localized diagnosis by combining imaging examination. However, in some cases, the primary tumor metastasizes outside the ovary and forms small nodules scattered in the pelvis when the primary tumor is still small. At this time, it is advisable to choose some special examination methods to assist in diagnosis (qualitative diagnosis), and should not rely solely on follow-up and miss the treatment opportunity.

3. Qualitative diagnosis

Although diagnostic technology is changing with each passing day, the posterior vaginal fornix aspiration smear examination, the rectouterine pouch puncture fluid examination and the 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 transvaginal ultrasound scanning, can help make a qualitative diagnosis of the boundaries (extent of involvement) and internal structure (nature) of early ovarian malignancies.

Endocrine examination is helpful for 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. has high sensitivity to ovarian malignant tumors, but its specificity is poor, so its type cannot be determined by a single immunological test. 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.