Analysis of falsely elevated risk of ovarian malignancy algorithm in women with ovarian endometrioma.
10.5468/ogs.2016.59.4.295
- Author:
Jae Jun SHIN
1
;
Ye Ji LEE
;
Ranah KIM
;
Da Yong LEE
;
Kyu Hee WON
;
Byung Chul JEE
Author Information
1. Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. blasto@snubh.org
- Publication Type:Original Article
- Keywords:
Endometriosis;
False positive;
Risk of ovarian malignancy algorithm
- MeSH:
Endometriosis*;
Epididymis;
Female;
Humans;
Incidence;
Kidney Failure, Chronic;
Male;
Roma
- From:Obstetrics & Gynecology Science
2016;59(4):295-302
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To estimate the incidence of falsely elevated risk of ovarian malignancy algorithm (ROMA) in a group of women with pathologically confirmed endometrioma and to investigate the associated factors. METHODS: One hundred premenopausal women surgically diagnosed with ovarian endometrioma were selected. Preoperative clinical, laboratory, and surgical characteristics were compared between the elevated-risk group (ROMA-premenopausal value, ≥7.4%) and normal-risk group (ROMA-premenopausal value, <7.4%). RESULTS: Elevated ROMA was observed in 15 women (false positive rate, 15%). Excluding one woman with known chronic renal failure, we compared the characteristics of 99 women between the elevated-risk group (n=14) and the normalrisk group (n=85). None of the clinical and surgical variables distinguished the two groups. Serum level of CA 125 >82.3 U/mL and serum level of human epididymis protein 4 (HE4) >46 pmol/L could predict an elevated ROMA test with a statistical significance. When serum level of HE4 ≤46 pmol/L, none of the women showed an elevated ROMA test, regardless of serum level of CA 125; however, 55.6% of the women showed an elevated ROMA test when serum level of HE4 >46 pmol/L and CA 125 ≤82.3 U/mL and all women showed an elevated ROMA test when serum level of HE4 >46 pmol/L and CA 125 >82.3 U/mL. CONCLUSION: The incidence of falsely elevated ROMA was 15% in the group of women with pathologically confirmed endometrioma. Interpretation of the ROMA results should be cautious when serum level of HE4 >46 pmol/L and CA 125 >82.3 U/mL in women with suspicious ovarian endometrioma.
