EP23.26: Prospectively evaluate the solid components in differentiating epithelial borderline ovarian tumour from invasive ovarian cancer

To prospectively evaluate the diagnostic value of papillary projection and other solid components in differentiating epithelial borderline ovarian tumour from invasive ovarian cancer. We collected the adnexal masses detected by ultrasonography between September 2019 to December 2021 and underwent preoperative examination and surgical treatment, prospectively. Transvaginal or transrectal two- and three-dimensional ultrasound were used to evaluate papillary projection and other solid components of tumours. The postoperative histopathological diagnosis was used as reference standard. Multivariate logistic regression analysis determined the indicators related to the invasiveness of ovarian cancer, which is helpful to distinguish epithelial borderline ovarian tumour from invasive ovarian cancer. A total of 363 cases of epithelial ovarian tumours, including 170 cases of benign tumours, 96 cases of borderline tumours and 97 cases of primary invasive ovarian cancer, were included. Women with CA125>100 U/mL had almost five times greater likelihood of belonging in invasive ovarian cancer. In contrast, the presence of papillary projections was associated with a 79% lower likelihood for invasive ovarian cancer. Women younger than 40 years old were associated with a 58% lower in the likelihood of malignancy. Compared with invasive ovarian cancer, the smaller papillary projection contains cluster with 1-3mm thin-walled anechoic cystic structures was highly associated with borderline ovarian tumour. When differentiating epithelial borderline ovarian tumours from invasive ovarian cancer, CA125>100 U/mL seems to improve the discriminative ability in favour of invasive ovarian cancer than borderline tumours. Women younger than 40 years old and presence of papillary projection suggest a borderline ovarian tumour. The smaller papillary projection contains cluster with 1-3mm thin-walled anechoic cystic structures which was highly associated with borderline ovarian tumour.