Ovarian cancer is a common gynecologic malignancy, and it is the gynecologic tumor with the worst prognosis. The five-year survival rate for early-stage ovarian cancer can reach 90%, but for advanced cases, the five-year survival rate is still only 30-40% even with all-out treatment. One of the major reasons for the poor prognosis of ovarian cancer is that it is often diagnosed at an advanced stage because of its insidious onset, hence its cold nickname: silent killer. Ovarian cancer usually has no obvious discomfort in the early stage, and only in the advanced stage will there be obvious symptoms, including: abdominal (gastrointestinal) discomfort, belching, indigestion, bloating or pain; nausea, vomiting, diarrhea, constipation, frequent urination; poor appetite; bloating even when eating little food; unexplained weight gain or loss; and abnormal vaginal bleeding. These symptoms can be caused by ovarian cancer or other less serious diseases, but it is important to have these symptoms checked by a doctor as soon as they are detected. In order to find the cause of these symptoms, the doctor will analyze the woman’s medical history and perform a physical examination and some special tests, including the following: pelvic examination including examination of the uterus, vagina, ovaries, fallopian tubes, bladder and rectal fossa for abnormalities (shape, size, presence of masses). Ultrasound This is a sound wave that cannot be heard by humans. The image formed by the reflection of the sound wave can clearly show the difference between normal ovaries, fluid cysts and tumor tissue. CA-125 analysis The tumor marker CA-125 is often higher in the blood of ovarian cancer patients than in normal women. CT scan It can clearly show all levels in the body Pathological section examination For ovarian tumors of unknown nature, pathological tissues can be obtained through exploratory surgery by dissection and analyzed in frozen sections under a microscope. If the diagnosis of ovarian cancer is confirmed intraoperatively, maximum tumor cytoreduction is performed. Some patients were told that they were benign cysts and neglected the treatment, which led to lifelong regret of tumor degeneration; some were referred from gastroenterology or internal medicine departments, and because of “treating the headache to cure the foot”, the ascites grew more and more. In clinical practice, the main diseases that need to be differentiated from ovarian cancer are: 1. pelvic endometriosis The symptoms of ovarian cancer are very similar to those of adherent ovarian masses and rectal sunken nodules, but this disease is often differentiated from ovarian cancer in patients of reproductive age, with progressive dysmenorrhea that worsens with menstrual cycle and infertility. If necessary, abdominal or cesarean exploration is performed to confirm the diagnosis. 2, adnexal tuberculosis or peritoneal tuberculosis Often there is a history of tuberculosis, and its clinical manifestations are different. Adnexal tuberculosis has symptoms such as wasting, low fever, night sweats, flushing, postmenstrual error and thinning, amenorrhea. In peritoneal tuberculosis ascites appears as an adherent mass, characterized by high location. Ultrasound and X-ray gastroenterography can help to confirm the diagnosis and facilitate identification. 3.Pelvic inflammatory mass Inflammation can form a substantial, uneven and fixed mass, or parametritis with inflammatory infiltration reaching the pelvic wall, similar to ovarian cancer symptoms. Patients with pelvic inflammatory masses often have a history of abortion, IUD, IUD removal, and postpartum infection. Pelvic inflammatory disease is mainly characterized by clinical manifestations such as fever, lower abdominal pain, long duration of the disease, and obvious tenderness on bimanual examination, and the mass shrinks with the application of anti-inflammatory treatment. When necessary, cytological examination of the mass should be carried out. 4, cirrhosis ascites According to the performance of cirrhosis symptoms, liver function test results, pelvic examination of the presence of masses, ascites properties, etc., it is not difficult to identify, if necessary, B ultrasound, CT and other auxiliary examinations. Benign ovarian tumors Benign tumors have a relatively long course, the masses gradually increase in size, often occurring unilaterally, with good mobility, soft texture, flat and smooth surface, intact envelope and no defects. On the contrary, ovarian malignant tumor has a short course and the mass grows faster, with poor mobility, hard texture and unsmooth surface. If necessary, laparoscopy and abdominal dissection can be performed to further clarify the diagnosis. In order to diagnose and treat ovarian cancer at an early stage, we hope women will pay attention to the following two points: 1) Annual check-up for women of childbearing age and semi-annual check-up for women over 50 years old. 2. Pay high attention to ovarian tumors. Do not abuse hormonal drugs and tonic medicines, be cautious about the so-called ovarian maintenance, and be determined to operate on cysts larger than 5cm in diameter, cysts that continue to grow, cysts containing solid components or papillae, and don’t feed the tiger as a problem. Postmenopausal women who find ovarian tumors should be operated regardless of the size of the cystic solid tumor. I hope we can all keep our eyes open and let this silent killer of ovarian cancer have nowhere to hide.