Explore the value of the Ovarian-Adnexal Reporting and Data System combined with tumor markers in the differential diagnosis of benign and malignant ovarian-adnexal tumors

Purpose: To explore the value of the Ovarian-Adnexal Reporting and Data System (O-RADS) combined with tumor markers (ROMA) in the differential diagnosis of benign and malignant ovarian-adnexal tumors. Methods: A total of 426 patients with 524 cases of ovarian-adnexal tumors confirmed by surgery from January 2021 to January 2024 were included. Ultrasound O-RADS classification, ROMA and their combination were used for differential diagnosis. Taking pathological results as the gold standard, the sensitivity, specificity and the area under the receiver operating characteristic (ROC) curve were calculated. Results: Among the 524 tumors, there were 104 cases in category 2, 113 cases in category 3, 81 cases in category 4, 226 cases in category 5. The proportions of malignancy in O-RADS categories 2-5 were 0% (0/104), 4.42% (5/113), 53.09% (43/81) and 97.34% (220/226). Thus, it can be seen that the higher the ultrasound O-RADS classification, the higher the risk of malignancy was. The difference is statistically significant (P < 0.0001). Taking O-RADS category 4 as the research object, the patients were divided into two groups with pre-menopausal and post-menopausal for statistical analysis. The results showed that the malignancy rate of postmenopausal O-RADS category 4 tumors was similar to that of O-RADS category 5. The risk of malignant tumors in postmenopausal women with O-RADS category 4 is significantly higher than that in premenopausal patients and the difference is statistically significant (P < 0.01). The diagnostic efficacy of ROMA for benign and malignant tumors in postmenopausal patients were significantly greater than in premenopausal patients. The difference was statistically significant (P < 0.001). When combined diagnosis is adopted, regardless of whether it is in the premenopausal or postmenopausal stage, the sensitivity and specificity of the diagnosis are significantly higher than those of a single diagnosis. Conclusion: Taking O-RADS category 4 as the research object, the incidence of malignant tumors of O-RADS category 4 in postmenopausal women is similar to that of category 5. The diagnostic efficacy of ROMA for postmenopausal patients is greater than that for premenopausal patients. The use of O-RADS classification combined with ROMA can significantly improve the sensitivity and specificity for the differential diagnosis of benign and malignant ovarian-adnexal tumors.