1.Cytologic examination of ascites Puncture of the iliac fossa of the lower abdomen, and if there is little ascites, puncture can be performed through the posterior vault to draw ascites for cancer cells. 2.Tumor marker determination (1) CA125: It has important reference value for the diagnosis of ovarian epithelial carcinoma, especially plasmacytoid cystic adenocarcinoma, followed by endometrioid carcinoma. The positive rate of detection for plasmacytoid cystic carcinoma is over 80%, and over 90% of CA125 levels wax and wane with remission or deterioration, so it can also be used as post-treatment monitoring. The positive rate for advanced ovarian cancer is high, but the positive rate for stage I ovarian malignancy is only 50%. CA125 is not specific, and CA125 values may also be elevated in some gynecological non-malignant diseases such as acute pelvic inflammatory disease, endometriosis, pelvic and abdominal tuberculosis, ovarian cysts, uterine fibroids and some non-gynecological diseases. Wu Longxiang, Department of Hepatobiliary Oncology, Nantong Cancer Hospital (2) AFP: It has specific value for ovarian endodermal sinus tumor. AFP can be used as an important marker for germ cell tumors before and after treatment and for follow-up. The normal value is <29 μg/L. (3) HCG: HCG is abnormally elevated in the blood of patients with germ cell tumors with primary ovarian choriocarcinoma component. Normal non-pregnant women have negative serum B subunit HCG values or <3.1 mg/ml. (4) CEA: CEA is abnormally elevated in some advanced ovarian malignancies, especially mucinous cystic adenocarcinoma. However, it is not a specific antigen for ovarian tumors. (5) LDH: LDH is elevated in the serum of some ovarian malignant tumors, especially in asexual cell tumors, but it is not a specific indicator for ovarian tumors. (6) Sex hormones: granulosa cell tumors and follicular membrane tumors can produce high levels of estrogen; when luteinized, they can also secrete testosterone. Plasmacytoma, mucinous or fibroepithelial tumors can sometimes also secrete some amount of estrogen. 3.Flow cytometry cellular DNA measurement Flow cytometry (Fcm) method is used to analyze the DNA map by flow cytometry to understand the DNA content of tumor. The DNA content of ovarian malignant tumors correlated with histological classification, grading, clinical stage, recurrence and survival rate of the tumors. The relationship between prognosis and DNA ploidy in 290 stage I epithelial ovarian malignancies was investigated by Vergote, who found that diploid tumors were mostly stage I G1, mucinous or endometrioid carcinomas, whereas heterodiploid tumors were mostly stage Ic G3, plasmacytotic or clear cell carcinomas, with no recurrence in the low-risk group (diploid tumors) and 25% recurrence in the high-risk group (heterodiploid tumors.) Trope et al. concluded that DNA ploidy analysis is an important prognostic indicator second only to histologic grading. Ultrasonography is an important tool for the diagnosis of ovarian tumors. It can determine tumor size, location, texture, relationship with uterus and the presence of ascites. The judgment of benign and malignant depends on experience and can be 80% to 90%. However, it is difficult to diagnose tumor below 2cm by ultrasound. Vaginal ultrasonography, especially vaginal color Doppler ultrasonography, can show the changes of blood flow in the tumor and provide reference for distinguishing benign from malignant. 2.CT and MRI examination It is valuable to judge the size, texture and relationship between tumor and pelvic organs, especially for the enlargement of pelvic and para-aortic lymph nodes. 3.Lymphangiography can show the iliac ducts and para-aortic lymph nodes and their metastatic signs, and provide preoperative evaluation and preparation for lymph node dissection. 4.Select the following tests if necessary (1) Gastroscopy and colonoscopy: to identify primary gastrointestinal tract primary cancer with ovarian metastases. (2) Intravenous pyelogram: to understand the secretion and excretion function of the kidney, urinary tract compression and obstruction symptoms. (3) Radioimmunoimaging: using radionuclide labeled antibody as positive tumor developer for tumor localization and diagnosis. (4) Laparoscopic examination: for pelvic masses that are difficult to be characterized clinically, laparoscopic examination of patients with ascites to take biopsies and ascites to do pathology and cytology tests for characterization and preliminary clinical staging.