Clinical value of combining transvaginal contrast-enhanced ultrasonography with serum human epididymisprotein-4 and the resistance index for early-stage epithelial ovarian cancer

OBJECTIVES To increase accuracy of the detection and differential diagnosis of the early epithelial ovarian cancer (EOC) with transvaginal contrast-enhanced ultrasonography (TVCEUS) combining serum human epididymisprotein 4 (HE4), and resistance index (RI). Methods: This retrospectively case-control study of 230 patients with ovarian tumors were reviewed at the Department of Gynecology and Obstetrics, Zhongnan Hospital, Wuhan University, Wuhan, China between June 2008 and September 2015. Before the operation of 110 cases with EOC (Group A) and 120 cases of patients with benign ovarian tumor (Group B), we observe and calculate both Groups' tumor vascular contrast-enhanced ultrasonography morphology scores (U), time-intensity curve (TIC) of contrast-enhanced ultrasonography, HE4, and RI. Results were compared with the histopathological analysis results. Results: The ultrasonography morphology scores, peak intensity (PI) enhancement rate (ER) with the parameters of the TIC and HE4 are higher in Group A compared with patients in Group B and the RI was lower than Group B. The detection rates for all indexes in the benign and malignant groups and their comparisons to the histopathological results were determined. The detection rate differences for HE4 (p=0.001), RI (p=0.001), U (p=0.001), PI (p=0.001), and ER (p=0.001) were all statistically significant (p less than 0.05).  Conclusion: The high clinical value through combined TVCEUS, HE4, and RI detection can increase the sensitivity of the diagnosis and differential diagnosis of the early EOC.