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The use of CA125, human epididymis protein 4 (HE4), risk of ovarian malignancy algorithm (ROMA), risk of malignancy index (RMI) and subjective assessment (SA) in preoperative diagnosing of ovarian tumors

Lukasz Janas1, Grzegorz Stachowiak1, Ewa Glowacka2, Iwona Piwowarczyk1, Magdalena Kajdos1, Malwina Soja1, Martyna Masternak1, Marek Nowak1
Affiliations
  1. Department of Operative Gynecology and Gynecologic Oncology, Polish Mother’s Memorial Hospital — Research Institute, Lodz, Poland
  2. Centre of Medical Laboratory Diagnostics, Polish Mother’s Memorial Hospital — Research Institute, Lodz, Poland

open access

Ahead of Print
ORIGINAL PAPERS Gynecology
Published online: 2022-12-28

Abstract

Objectives: To compare utility of CA125, human epididymis protein 4 (HE4), risk of ovarian malignancy algorithm (ROMA), risk of malignancy index (RMI) and subjective assessment (SA) in preoperative diagnosis of ovarian tumors. Material and methods: Research was conducted among 456 patients qualified for surgery due to ovarian tumor. Preoperatively, CA125 and HE4 serum levels were estimated, and transvaginal ultrasound was performed. ROMA and RMI values and SA qualifications were obtained. Results were compared with pathomorphological findings. Results: Receiver Operating Characteristic (ROC)-Area Under Curve (AUC) values for CA125, HE4, ROMA, RMI and SA in preoperative diagnosis of malignant lesions were 0.819, 0.909, 0.911, 0.895 and 0.895, respectively. Combinations of biochemical and sonographic methods increased sensitivity in diagnosis of ovarian tumors. Combinations utilizing serum HE4 concentrations were most useful. Conclusions: CA125, HE4, ROMA, RMI and SA proved to be useful in preoperative diagnosis of ovarian tumors. HE4 and ROMA occurred to be the most useful. Ultrasonographic methods are considerably useful in diagnosis of ovarian tumors. RMI and SA present similar overall diagnostic value.

Abstract

Objectives: To compare utility of CA125, human epididymis protein 4 (HE4), risk of ovarian malignancy algorithm (ROMA), risk of malignancy index (RMI) and subjective assessment (SA) in preoperative diagnosis of ovarian tumors. Material and methods: Research was conducted among 456 patients qualified for surgery due to ovarian tumor. Preoperatively, CA125 and HE4 serum levels were estimated, and transvaginal ultrasound was performed. ROMA and RMI values and SA qualifications were obtained. Results were compared with pathomorphological findings. Results: Receiver Operating Characteristic (ROC)-Area Under Curve (AUC) values for CA125, HE4, ROMA, RMI and SA in preoperative diagnosis of malignant lesions were 0.819, 0.909, 0.911, 0.895 and 0.895, respectively. Combinations of biochemical and sonographic methods increased sensitivity in diagnosis of ovarian tumors. Combinations utilizing serum HE4 concentrations were most useful. Conclusions: CA125, HE4, ROMA, RMI and SA proved to be useful in preoperative diagnosis of ovarian tumors. HE4 and ROMA occurred to be the most useful. Ultrasonographic methods are considerably useful in diagnosis of ovarian tumors. RMI and SA present similar overall diagnostic value.

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Keywords

serum tumor markers; preoperative assessment of adnexal mass; ovarian cancer; endometriosis

About this article
Title

The use of CA125, human epididymis protein 4 (HE4), risk of ovarian malignancy algorithm (ROMA), risk of malignancy index (RMI) and subjective assessment (SA) in preoperative diagnosing of ovarian tumors

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2022-12-28

Page views

592

Article views/downloads

530

DOI

10.5603/GP.a2022.0144

Pubmed

36597746

Keywords

serum tumor markers
preoperative assessment of adnexal mass
ovarian cancer
endometriosis

Authors

Lukasz Janas
Grzegorz Stachowiak
Ewa Glowacka
Iwona Piwowarczyk
Magdalena Kajdos
Malwina Soja
Martyna Masternak
Marek Nowak

References (30)
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