Objective To investigate the clinical utility and value Ovarian Adnexal Reporting and Data System 2022 versionO-RADS (v2022) combines with the detection of tumor markers serum carbohydrate antigen CA125 and human epididymal secretory protein HE4 in differentiating benign and malignant ovarian masses.

Methods The clinical data of 263 patients who visited the First Affiliated Hospital of Bengbu Medical University due to ovarian mass problems and had clear pathological results were collected. Taking the histopathological diagnosis conclusion as the gold standard, the patients were divided into the benign group and malignant group. The detection rates of ovarian malignant masses by O-RADS classification, serological CA125 level detection, HE4 protein detection and combined application of the three were evaluated, and the sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and coincidence rate of each index were compared. The receiver operating characteristic (ROC) curve was draw, and the area under the curve (AUC) was calculated.

Results According to the pathological results, among 263 ovarian masses, 166 cases were benign masses and 97 cases were malignant masses. The detection rates of O-RADS categories 5, 4, 3 and 2 in malignant masses were 93.33%, 46.91%, 3.37% and 0%, respectively. Compared with benign masses, the differences were statistically significant (P ＜ 0.01). The detection rates of CA125 and HE4 in malignant masses were 65.08% and 85.96%, respectively, and the difference was statistically significant compared with benign masses (P ＜ 0.01). There was no statistically significant difference in the sensitivity between the combined detection of the three and individual application of O-RADS classification (P ＞ 0.05), but it was superior to CA125 and HE4 (P ＜ 0.05). The specificity of the combined detection of the three was superior to that of O-RADS and CA125 alone (P ＜ 0.05). The coincidence rate of the combined detection of the three was better than those of CA125, HE4 and O-RADS alone (P ＜ 0.05). The analysis results of the ROC curve showed that the AUCs of O-RADS classification, CA125, HE4 and combined detection of the three were 0.849, 0.790, 0.737 and 0.903, respectively, and the statistical analysis of AUC showed that the difference was statistically significant (P ＜ 0.05).

Conclusions The O-RADS classification, CA125 and HE4 all have certain diagnostic values for malignant ovarian masses. Compared with a single indicator, the combined detection of the three shows higher diagnostic efficiency, and is of great significance for the early diagnosis of malignant ovarian masses.