Validity of serum CA-125, HE4 and ROMA in preoperative prediction of ovarian cancer

Abstract

Objectives: To evaluate the validity of serum CA-125, HE4 and ROMA in preoperative prediction of ovarian cancer.

Materials and Methods: cross-sectional, descriptive study on 277 patients hospitalized at the OBGYN Department, Hue Central Hospital from Jan 2016 to November 2017. All patients have completed history taking, measurements of serum CA-125 and HE4 using ARCHITECT HE4 kits; ROMA calculated, and risk of preoperative malignancy estimated. These values were matched postoperatively to the histopathological results to calculate the preoperative prediction values.

Results: There were 30 (10,8%) cases of ovarian cancer. Median values of CA 125, HE4, and ROMA of ovarian cancer and benign ovarian were 214,20 U/ml and 17,45 U/ml; 90,00 pM and 38,50 pM; 55,20% and 4,47%, respectively. The sensitivities and specificity associated with the ability of CA125, HE4, ROMA, to distinguish between malignant versus benign ovarian masses were 83,33% and 78,14%; 50% and 98,38%; 80% and 84,62%, respectively. Areas under the ROC curve of CA-125, HE4, ROMA were 0,872; 0,894; and 0,912 respectively. With optimal cutoff values 9,35% for ROMA, the sensitivity and specificity were 86.7% and 88.7%, respectively.

Conclusion: All three of CA 125, HE4, and ROMA have good validity in the diagnosis of ovarian cancer. Areas under the ROC curve of CA-125, HE4, ROMA were 0,872; 0,894; and 0,912 respectively, of which ROMA gives the highest results. The ROMA index should be widely applied in clinical practice to help assess, manage and predict patients with suspected ovarian cancer.