Document Detail

A comparison of CA125, HE4, risk ovarian malignancy algorithm (ROMA), and risk malignancy index (RMI) for the classification of ovarian masses.
MedLine Citation:
PMID:  22666786     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Differentiation between benign and malignant ovarian neoplasms is essential for creating a system for patient referrals. Therefore, the contributions of the tumor markers CA125 and human epididymis protein 4 (HE4) as well as the risk ovarian malignancy algorithm (ROMA) and risk malignancy index (RMI) values were considered individually and in combination to evaluate their utility for establishing this type of patient referral system.
METHODS: Patients who had been diagnosed with ovarian masses through imaging analyses (n = 128) were assessed for their expression of the tumor markers CA125 and HE4. The ROMA and RMI values were also determined. The sensitivity and specificity of each parameter were calculated using receiver operating characteristic curves according to the area under the curve (AUC) for each method.
RESULTS: The sensitivities associated with the ability of CA125, HE4, ROMA, or RMI to distinguish between malignant versus benign ovarian masses were 70.4%, 79.6%, 74.1%, and 63%, respectively. Among carcinomas, the sensitivities of CA125, HE4, ROMA (pre-and post-menopausal), and RMI were 93.5%, 87.1%, 80%, 95.2%, and 87.1%, respectively. The most accurate numerical values were obtained with RMI, although the four parameters were shown to be statistically equivalent.
CONCLUSION: There were no differences in accuracy between CA125, HE4, ROMA, and RMI for differentiating between types of ovarian masses. RMI had the lowest sensitivity but was the most numerically accurate method. HE4 demonstrated the best overall sensitivity for the evaluation of malignant ovarian tumors and the differential diagnosis of endometriosis. All of the parameters demonstrated increased sensitivity when tumors with low malignancy potential were considered low-risk, which may be used as an acceptable assessment method for referring patients to reference centers.
Cristina Anton; Filomena Marino Carvalho; Elci Isabel Oliveira; Gustavo Arantes Rosa Maciel; Edmund Chada Baracat; Jesus Paula Carvalho
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinics (São Paulo, Brazil)     Volume:  67     ISSN:  1980-5322     ISO Abbreviation:  Clinics (Sao Paulo)     Publication Date:  2012  
Date Detail:
Created Date:  2012-06-05     Completed Date:  2013-02-25     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  101244734     Medline TA:  Clinics (Sao Paulo)     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  437-41     Citation Subset:  IM    
Hospital das Clínicas da Faculdade de Medicina da Unversidade de São Paulo, Obstetrics and Gynecology, Brazil.
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MeSH Terms
Aged, 80 and over
CA-125 Antigen / analysis*
Endometriosis / diagnosis
Ovarian Neoplasms / diagnosis*
Prospective Studies
Proteins / analysis*
Referral and Consultation / standards*
Risk Assessment
Sensitivity and Specificity
Tumor Markers, Biological / analysis*
Young Adult
Reg. No./Substance:
0/CA-125 Antigen; 0/Proteins; 0/Tumor Markers, Biological; 0/WFDC2 protein, human

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