What tests should be done for ovarian tumors

Ovarian tumor refers to a tumor that occurs on the ovary. It is one of the common tumors of the female reproductive organs. Ovarian malignant tumors are also the tumor with the highest mortality rate among gynecological malignant tumors. Although great progress has been made in both basic research and clinical diagnosis and treatment of ovarian malignant tumors in recent years, unfortunately, its 5-year survival rate has not improved significantly. So, how to check for ovarian tumors? The following experts will introduce the methods of checking ovarian tumors.

1. Ascites cytology examination

Puncture the iliac fossa in the lower abdomen. If there is little ascites, puncture the posterior fornix to draw out the ascites and check for cancer cells.

2. Tumor marker determination

(1) CA125 is of great reference value for diagnosing epithelial ovarian cancer, especially serous cystadenocarcinoma, followed by endometrioid carcinoma. The positive detection rate of serous cystadenocarcinoma is over 80%, and more than 90% of CA125 levels rise and fall with the improvement or deterioration of the disease. Therefore, it can also be used for post-treatment monitoring. Clinically, CA125 ≥ 35U/ml is the positive standard. CA125 is not specific. The CA125 values ​​of some non-malignant gynecological diseases such as acute pelvic inflammatory disease, endometriosis, pelvic and abdominal tuberculosis, ovarian cysts, uterine fibroids and some non-gynecological diseases are also sometimes elevated.

(2) AFP has specific value for ovarian endodermal sinus tumor. Mixed tumors, dysgerminomas, embryonal tumors, and some immature teratomas containing endodermal sinus tumor components may also be elevated. AFP can be used as an important marker before and after treatment and follow-up of germ cell tumors. The normal value is <29μg/L.

(3) HCG: The HCG level in the blood of patients with primary ovarian choriocarcinoma germ cell tumors is abnormally elevated, while the HCG value of the serum B subunit in normal non-pregnant women is negative or <3.1 mg/ml.

(4) CEA In some advanced ovarian malignancies, especially mucinous cystadenocarcinoma, CEA is abnormally elevated. However, it is not a specific antigen for ovarian tumors.

(5) LDH: LDH levels are elevated in the serum of some ovarian malignancies, especially dysgerminoma, but it is not a specific indicator for ovarian tumors.

(6) Sex hormone granulosa cell tumors and thecomas can produce high levels of estrogen; when luteinized, they can also secrete testosterone. Serous, myxoma, or fibroepithelioma can sometimes secrete a certain amount of estrogen.

3. Flow cytometry cell DNA determination

Flow cytometry (Fcm) is a method to analyze DNA patterns using a flow cytometer to understand the DNA content of tumors. The DNA content of ovarian malignant tumors is related to the histological classification, grade, clinical stage, recurrence and survival rate of tumors.

4. Imaging examination

(1) Ultrasound examination is an important means of diagnosing ovarian tumors. It can determine the size, location, texture, relationship with the uterus, and presence of ascites.

(2) CT and MRI examinations are valuable in determining the size and texture of the tumor, and its relationship to the pelvic organs, especially the enlargement of the pelvic and para-aortic lymph nodes.

(3) Lymphangiography can show the iliac vessels and para-aortic lymph nodes and their metastatic signs, providing preoperative evaluation and preparation for lymph node dissection.

5. Others

(1) Gastroscopy and colonoscopy to identify ovarian metastases from primary gastrointestinal cancer.

(2) Intravenous pyelography is used to understand the secretion and excretion functions of the kidneys and the symptoms of urinary tract compression and obstruction.

(3) Radioimmunoassay uses radionuclide-labeled antibodies as tumor-positive imaging agents to perform tumor localization diagnosis.

(4) Laparoscopic examination is used for pelvic masses that are difficult to diagnose clinically. For patients with ascites, laparoscopic biopsy is performed and ascites is collected for pathological and cytological examinations to diagnose and perform preliminary clinical staging.