Vol 86, No 4 (2015)
ARTICLES
Diagnostic value of CA125, HE4, ROMA
and logistic regression model in pelvic mass
diagnostics – our experience
Marcin Michalak, Emilia Gąsiorowska, Ewa Nowak-Markwitz
DOI: 10.17772/gp/2070
·
Ginekol Pol 2015;86(4).
Vol 86, No 4 (2015)
ARTICLES
Abstract
Objectives: The aim of this study was to compare and evaluate the quality of CA125, HE4, logistic regression
model based on CA125 and HE4, and ROMA algorithm in preoperational differential diagnostics of the ovarian
tumors.
Material and methods: To the study 110 patients enrolled. Based on histopatological examination of removed
tumors, they were divided into study group (56 cancer patients) and control one (nonmalignant 54 patients). Serum
CA125 and HE4 concentrations were measured following a standard procedure.
Results: A commonly accepted referential value for CA125 is 35 IU/ml. In our study, this cut-off value yielded very
low sensitivity and specificity results (85.2% and 63.6%, respectively).
When we adopted HE4 normal value to be 140 pM,the sensitivity and specificity obtained in the investigated
population was 68.5% and 94.6%, respectively.
When the cut-off value for HE4 was adopted as 74 pM, the sensitivity improved considerably (88.9%), but specificity
decreased to 85.7%. In case of CA125 when we adopted Ca125 normal value to be 77 IU/ml, the sensitivity
and specificity obtained in the investigated population was 81.5% and 83.6%, respectively. In analysis based on
combination of biomarkers, the highest sensitivity was obtained for the logistic regression model based on CA125
and HE4 (89.5%). A little bit lower sensitivity was achieved for HE4 used as a single diagnostic test (88.9%).
The highest specificity was observed for ROMA algorithm (94.5%). This means that ROMA algorithm is the best
diagnostic tool to differentiate between the malignant and non-malignant ovarian tumors.
Conclusions:
1. ROMA algorithm yielded the highest specificity and slightly lower sensitivity in the case of differential
diagnosis between malignant and non-malignant ovarian tumors. Therefore, it should become a basic tool
in the ovarian tumors diagnosis prior to a surgery.
2. HE4 as a single diagnostic test (based on one marker) was found to be better suited to the ovarian tumor
differential diagnosis than CA125 test.
3. Combined test, based on double marker analysis, should be applied and then the risk of the ovarian
cancer should be calculated. This approach is more effective than single marker analysis.
Abstract
Objectives: The aim of this study was to compare and evaluate the quality of CA125, HE4, logistic regression
model based on CA125 and HE4, and ROMA algorithm in preoperational differential diagnostics of the ovarian
tumors.
Material and methods: To the study 110 patients enrolled. Based on histopatological examination of removed
tumors, they were divided into study group (56 cancer patients) and control one (nonmalignant 54 patients). Serum
CA125 and HE4 concentrations were measured following a standard procedure.
Results: A commonly accepted referential value for CA125 is 35 IU/ml. In our study, this cut-off value yielded very
low sensitivity and specificity results (85.2% and 63.6%, respectively).
When we adopted HE4 normal value to be 140 pM,the sensitivity and specificity obtained in the investigated
population was 68.5% and 94.6%, respectively.
When the cut-off value for HE4 was adopted as 74 pM, the sensitivity improved considerably (88.9%), but specificity
decreased to 85.7%. In case of CA125 when we adopted Ca125 normal value to be 77 IU/ml, the sensitivity
and specificity obtained in the investigated population was 81.5% and 83.6%, respectively. In analysis based on
combination of biomarkers, the highest sensitivity was obtained for the logistic regression model based on CA125
and HE4 (89.5%). A little bit lower sensitivity was achieved for HE4 used as a single diagnostic test (88.9%).
The highest specificity was observed for ROMA algorithm (94.5%). This means that ROMA algorithm is the best
diagnostic tool to differentiate between the malignant and non-malignant ovarian tumors.
Conclusions:
1. ROMA algorithm yielded the highest specificity and slightly lower sensitivity in the case of differential
diagnosis between malignant and non-malignant ovarian tumors. Therefore, it should become a basic tool
in the ovarian tumors diagnosis prior to a surgery.
2. HE4 as a single diagnostic test (based on one marker) was found to be better suited to the ovarian tumor
differential diagnosis than CA125 test.
3. Combined test, based on double marker analysis, should be applied and then the risk of the ovarian
cancer should be calculated. This approach is more effective than single marker analysis.
Keywords
ovarian cancer / ROMA / HE4 / CA 125
Title
Diagnostic value of CA125, HE4, ROMA
and logistic regression model in pelvic mass
diagnostics – our experience
Journal
Ginekologia Polska
Issue
Vol 86, No 4 (2015)
Page views
929
Article views/downloads
1118
DOI
10.17772/gp/2070
Bibliographic record
Ginekol Pol 2015;86(4).
Keywords
ovarian cancer / ROMA / HE4 / CA 125
Authors
Marcin Michalak
Emilia Gąsiorowska
Ewa Nowak-Markwitz