Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul 19;9(1):43.
doi: 10.1186/s13048-016-0254-7.

Preoperative HE4, CA125 and ROMA in the differential diagnosis of benign and malignant adnexal masses

Katarzyna M Terlikowska  1 , Bozena Dobrzycka  2 , Anna M Witkowska  1 , Beata Mackowiak-Matejczyk  3 , Tomasz Kamil Sledziewski  2 , Maciej Kinalski  4 , Slawomir J Terlikowski  5   6
Affiliations

Preoperative HE4, CA125 and ROMA in the differential diagnosis of benign and malignant adnexal masses

Katarzyna M Terlikowska et al. J Ovarian Res. .

Abstract

Background: The aim of this study was to evaluate HE4, CA125 and ROMA in the preoperative differentiation benign ovarian diseases from epithelial ovarian cancer depending on the menopausal status.

Methods: In order to estimate markers' concentrations in the serum of women with benign ovarian disease (n = 128) and with epithelial ovarian carcinoma (n = 96) the electrochemiluminescence (ECLIA) technique has been applied.

Results: Using the ROC analysis, although no statistical differences were found among their AUCs, the ROMA algorithm seems to be effective in gathering the diverse performance of HE4 and CA125. The AUC for HE4, CA125 and ROMA for all patients were: 0.895; 0.879 and 0.918, respectively. At established new optimal cutoff values for HE4, CA125 and ROMA we found higher specificity in postmenopausal compared to premenopausal women (96.9 vs 89.8 % and 97.7 vs 84.1 % and 95.9 vs 89.1 %, respectively). The sensitivity of HE4 in pre- and postmenopausal women was similar (83.5 vs 83.8 %), while for CA125 was the highest in premenopausal women (87.0 vs 84.1 %). For HE4, CA125 and ROMA the negative predictive value was high (97.6, 93.9 and 94.4 %, respectively).

Conclusions: The ROMA algorithm shows the best diagnostic performance to distinguish epithelial ovarian cancer from benign ovarian disease. We found the high specificity of HE4 and CA125 while differentiating ovarian benign diseases from epithelial ovarian cancer in postmenopausal women and the high sensitivity of CA125 in detecting epithelial ovarian cancer in premenopausal patients.

Keywords: CA125; HE4; Ovarian cancer; ROMA.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The ROC curves of HE4, CA125 and ROMA in all patients (a), premenopausal (b) and postmenopausal (c). Area under the ROC curve of HE4, CA125 and ROMA (a): 0.895 vs 0.879 vs 0.918, (b): 0.845 vs 0.833 vs 0.854 and (c): 0.916 vs 0.904 vs 0.931, respectively
See this image and copyright information in PMC

References

    1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet] International Agency for Research on Cancer: Lyon, France; 2013.
    1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, Forman D, Bray F. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49(6):1374–403. doi: 10.1016/j.ejca.2012.12.027. - DOI - PubMed
    1. Reports based on data of National Cancer Registry. The Maria Sklodowska-Curie Memorial Cancer Center. Department of Epidemiology and Cancer Prevetion, National Cancer Registry 2013. Available from: http://epid.coi.waw.pl/krn, accessed on 23 March 2016.
    1. Gharwan H, Bunch KP, Annunziata CM. The role of reproductive hormones in epithelial ovarian carcinogenesis. Endocr Relat Cancer. 2015;22(6):R339–63. doi: 10.1530/ERC-14-0550. - DOI - PubMed
    1. Dobrzycka B, Kinalski M, Piechocka D, Terlikowski SJ. The role of estrogens in angiogenesis in the female reproductive system. Endokrynol Pol. 2009;60(3):210–4. - PubMed