A comparison of CA125, HE4, risk ovarian malignancy algorithm (ROMA), and risk malignancy index (RMI) for the classification of ovarian masses


Autoria(s): Anton, Cristina; Carvalho, Filomena Marino; Oliveira, Elci Isabel; Rosa Maciel, Gustavo Arantes; Baracat, Edmund Chada; Carvalho, Jesus Paula
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

12/10/2013

12/10/2013

2012

Resumo

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.

Identificador

CLINICS, SAO PAULO, v. 67, n. 5, supl., Part 3, pp. 437-441, DEC 7, 2012

1807-5932

http://www.producao.usp.br/handle/BDPI/34188

10.6061/clinics/2012(05)06

http://dx.doi.org/10.6061/clinics/2012(05)06

Idioma(s)

eng

Publicador

HOSPITAL CLINICAS, UNIV SAO PAULO

SAO PAULO

Relação

CLINICS

Direitos

openAccess

Copyright HOSPITAL CLINICAS, UNIV SAO PAULO

Palavras-Chave #TUMOR MARKERS #BIOLOGICAL #OVARIAN NEOPLASMS #CA 125 ANTIGEN #EPIDIDYMAL SECRETORY PROTEINS #RISK ASSESSMENT #SENSITIVITY AND SPECIFICITY #CARCINOMA #CANCER #CA-125 #TUMORS #MEDICINE, GENERAL & INTERNAL
Tipo

article

original article

publishedVersion