Comparison of serum cancer antigen 125, human epididymis protein 4, ROMA, and CPH-I for diagnosis of ovarian cancer in Chinese patients with ovarian mass.
10.12122/j.issn.1673-4254.2019.12.02
- Author:
Shipeng GONG
1
;
Yongning CHEN
1
;
Yadi ZHANG
1
;
L I CHANYUAN
1
;
Qifan JIANG
1
Author Information
1. Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
- Publication Type:Journal Article
- Keywords:
Copenhagen index;
Risk of Ovarian Malignancy Algorithm;
cancer antigen 125;
differential diagnosis;
human epididymis protein 4;
ovarian neoplasms
- MeSH:
Algorithms;
Biomarkers, Tumor;
CA-125 Antigen;
Carcinoma, Ovarian Epithelial;
Female;
Humans;
Neoplasms, Glandular and Epithelial;
Ovarian Neoplasms;
Proteins;
Retrospective Studies;
WAP Four-Disulfide Core Domain Protein 2
- From:
Journal of Southern Medical University
2019;39(12):1393-1401
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To compare the performance of serum cancer antigen 125 (CA125), human epididymis protein 4 (HE4), Risk of Ovarian Malignancy Algorithm (ROMA) and Copenhagen index (CPH-I) for differential diagnosis of benign and malignant diseases in patients with ovarian mass.
METHODS:We retrospectively analyzed the data of 719 women with pelvic mass, and the performance of preoperative serum levels of CA125 and HE4, ROMA and CPH-I for differential diagnosis of the masses was compared.
RESULTS:Of the 710 women analyzed, 531 were diagnosed with benign ovarian lesions, 44 with borderline ovarian tumors (BOTs), 119 with epithelial ovarian cancers (EOCs), and 25 with non-EOCs. In differentiating ovarian cancer (OC) and BOT from benign lesions, the area under the receiver-operator characteristic (ROC) curve (AUC) was 0.854 for HE4, 0.856 for ROMA, 0.854 for CPH-I, and 0.792 for CA125, demonstrating better diagnostic performance of HE4, ROMA, and CPH-I than CA125 alone; the diagnostic sensitivity was 56.9% for HE4, 70.2% for CA125, 69.1% for ROMA, and 63.8% for CPH-I; the specificity was the best with HE4 (94.4%) and CPH-I (94.7%). In sub-analysis of EOC benign lesions, the AUCs of HE4, ROMA, and CPH-I increased to 0.946, 0.947, and 0.943, respectively, all greater than that of CA125 (0.888). In other sub-analyses, HE4, ROMA, and CPH-I all showed greater AUCs than CA125 alone.
CONCLUSIONS:This study confirms the accuracy of HE4, ROMA, and CPH-I for differentiating malignant from benign ovarian mass, and all these 3 tests show better performance than CA125. Furthermore, HE4 and CPH-I is superior to ROMA and CA125 in terms of specificity, while CA125 and ROMA have better diagnostic sensitivities.
