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

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.

The young stellar cluster [DBS2003] 157 associated with the H ii region GAL 331.31-00.34

We report a study of the stellar content of the near-infrared (NIR) cluster [DBS2003] 157 embedded in the extended H ii region GAL 331.31-00.34, which is associated with the IRAS source 16085-5138. JHK photometry was carried out in order to identify potential ionizing candidates, and the follow-up NIR spectroscopy allowed the spectral classification of some sources, including two O-type stars. A combination of NIR photometry and spectroscopy data was used to obtain the distance of these two stars, with the method of spectroscopic parallax: IRS 298 (O6 V, 3.35 +/- 0.61 kpc) and IRS 339 (O9 V, 3.24 +/- 0.56 kpc). Adopting the average distance of 3.29 +/- 0.58 kpc and comparing the Lyman continuum luminosity of these stars with that required to account for the radio continuum flux of the H ii region, we conclude that these two stars are the ionizing sources of GAL 331.31-00.34. Young stellar objects (YSOs) were searched by using our NIR photometry and mid-infrared (MIR) data from the Galactic Legacy Infrared Mid-Plane Survey Extraordinaire (GLIMPSE) survey. The analysis of NIR and MIR colourcolour diagrams resulted in 47 YSO candidates. The GLIMPSE counterpart of IRAS 16085-5138, which presents IRAS colour indices compatible with an ultracompact H ii region, has been identified. The analysis of its spectral energy distribution between 2 and m revealed that this source shows a spectral index a= 3.6 between 2 and m, which is typical of a YSO immersed in a protostellar envelope. Lower limits to the bolometric luminosity and the mass of the embedded protostar have been estimated as L= 7.7 x 10(3) L? and M= 10 M?, respectively, which correspond to a B0B1 V zero-age main sequence star.