Diagnostic value of transvaginal ultrasound combined with serum CA125 and HE4 in differentiating benign and malignant ovarian tumors

Background: This study aimed to evaluate the diagnostic value of transvaginal ultrasound combined with the serum carbohydrate antigen125 (CA125) and Human Epididymis Protein 4 (HE4) in distinguishing benign from malignant ovarian tumors. Methods: The data of 140 patients with ovarian tumors were retrospectively analyzed. According to the histopathological diagnosis divided into benign group (109 cases) and malignant group (31 cases). Clinical data, serum biomarkers and transvaginal ultrasound were collected. Multivariate logistic regression and receiver operating characteristic (ROC) curve were used to analyze the diagnostic value of each parameter. Results: No significant differences in body mass index (BMI) or history of abortion between the two groups (p > 0.05). The proportion of postmenopausal patients was significantly higher in malignant group than benign group (p < 0.05). The pulsatility index (PI) and systolic-to-diastolic ratio (S/D) were significantly lower in the benign group than malignant group (p < 0.05), the resistance index (RI) was lower in the benign group but did not reach statistical significance (p > 0.05). Serum CA125 and HE4 levels were significantly higher in the malignant group than benign group (p < 0.05). Multivariate logistic regression analysis showed that RI, PI, S/D, CA125 and HE4 were independent influencing factors for benign and malignant diagnosis of ovarian tumors (p < 0.05). ROC showed that RI, PI, S/D, CA125 and HE4 had diagnostic value, and the area under the curve (AUC) was 0.588, 0.643, 0.698, 0.735 and 0.711, respectively. The diagnostic accuracy of the above combination was the highest, with an AUC of 0.856. Conclusions: The diagnosis of benign and malignant ovarian tumors by transvaginal ultrasound is limited, and the detection of serum markers is not high. Transvaginal ultrasound combined with CA125 and HE4 can significantly improve the accuracy of diagnosis, and has high clinical application value.