Differential diagnosis between pelvic tuberculosis and ovarian epithelial cancer
10.3760/cma.j.cn115355-20230609-00570
- VernacularTitle:盆腔结核与卵巢上皮性癌的鉴别诊断
- Author:
Meng TONG
1
;
Jing TANG
;
Junning JING
Author Information
1. 甘肃省妇幼保健院妇科，兰州 730000
- Keywords:
Tuberculosis, female genital;
Carcinoma, ovarian epithelial;
Diagnosis, differential;
Carbohydrate antigen 125
- From:
Cancer Research and Clinic
2024;36(8):600-603
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the main points of differential diagnosis between pelvic tuberculosis and ovarian epithelial cancer.Methods:A retrospective case series study was conducted. The clinical data of 336 patients with pelvic mass admitted to Gansu Provincial Maternal and Child-Care Hospital from January 2012 to July 2020 were collected, and they were divided into pelvic tuberculosis group (112 cases) and ovarian epithelial cancer group (224 cases) according to postoperative pathological examination results. The clinical symptoms, tumor markers, gynecologic color ultrasound and imaging examination results between the 2 groups were compared.Results:Abdominal distension [81.25% (91/112) vs. 82.14% (184/224)], anorexia [35.71% (40/112) vs. 32.15% (72/224)] and pelvic mass [42.86% (48/112) vs. 43.30% (97/224)] were the first symptoms in both pelvic tuberculosis group and ovarian epithelial cancer group, and the differences were statistically significant (all P > 0.05). The levels of carbohydrate antigen 125 (CA125), human epididymal protein 4 (HE4) and carbohydrate antigen 724 (CA724) in pelvic tuberculosis group were lower than those in ovarian epithelial cancer group, and the differences were statistically significant (all P < 0.05). The receiver operating characteristic curve showed that HE4 had the highest area under the curve (0.943), its optimal cut-off value was 92.54 pmol/L and the detection rate reached 85.7%. HE4 had the highest sensitivity in the diagnosis of the ovarian cancer. The proportion of cystic mass in pelvic tuberculosis group was higher compared with that in ovarian epithelial cancer group, and the difference was statistically significant [42.9% (48/112) vs. 12.5% (28/224), χ2 = 39.31, P = 0.001]. The incidence of retroperitoneal lymph node enlargement in ovarian epithelial cancer group was higher than that in pelvic tuberculosis group, and the difference was statistically significant [55.4% (124/224) vs. 0, P = 0.001]. Conclusions:The differential diagnosis between pelvic tuberculosis and ovarian epithelial cancer mainly depends on tumor markers, ultrasound, imaging findings. The levels of CA125 and HE4 in ovarian epithelial cancer group are higher than those in pelvic tuberculosis group, and the combined examination of CA125 and HE4 could be more conducive to differential diagnosis between pelvic tuberculosis and ovarian epithelial cancer.
