Department of Clinical Laboratory, Tianjin Central Hospital of Gynecology Obstetrics, 156 Nankai 3rd Road, Nankai District, Tianjin, 300100, China.
Clin Transl Oncol. 2017 Oct;19(10):1260-1267. doi: 10.1007/s12094-017-1664-8. Epub 2017 Apr 25.
The significance of the Risk of Ovarian Malignancy Algorithm (ROMA) in differentiating benign and malignant ovarian lesions has been evidenced. In our clinical work, we found that advanced ovarian cancer were accompanied commonly with high ROMA scores. Thus, this study aimed to clarify the performance of ROMA in different disease stage of epithelial ovarian cancer (EOC) prior to surgery.
Carbohydrate antigen (CA125) and human epididymis protein 4 (HE4) levels and ROMA scores in 221 patients with FIGO stage I, II or III/IV stage EOC were analyzed. The positive rates of CA125, HE4 and ROMA at each disease stage were calculated. Their cutoff values, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for distinguishing patients with FIGO stage I/II from those with FIGO stage III/IV were estimated via ROC curves.
Serum CA125 and HE4 levels and ROMA scores rose significantly with advancing stage. ROMA and CA125 were significantly elevated more frequently in comparing with HE4 in EOC patients at with the same stage. Based on ROC curves, the cutoff values for FIGO stage III/IV EOC were 110 IU/mL, 126 pmol/L, 78 and 68% for CA125, HE4, premenopausal and postmenopausal ROMA, respectively. ROMA was the strongest predictor of FIGO stage, with the highest specificity, accuracy, and PPV, which were 84.4, 82.5, and 87.0% for postmenopausal patients, 89.3, 85.6, and 74.3% for premenopausal patients.
Our data suggest high ROMA scores correlated with advanced ovarian cancer prior to surgery. These observations suggest potential utility of ROMA in the comprehensively preoperative evaluation of EOC patients.
卵巢恶性肿瘤风险算法（ROMA）在区分良性和恶性卵巢病变方面的意义已得到证实。在我们的临床工作中，发现晚期卵巢癌常伴有较高的 ROMA 评分。因此，本研究旨在明确 ROMA 在术前不同上皮性卵巢癌（EOC）疾病分期中的表现。
分析 221 例FIGO Ⅰ期、Ⅱ期或Ⅲ/Ⅳ期 EOC 患者的糖抗原（CA125）和人附睾蛋白 4（HE4）水平及 ROMA 评分。计算各疾病分期 CA125、HE4 和 ROMA 的阳性率。通过 ROC 曲线估计区分 FIGO Ⅰ/Ⅱ期和 FIGO Ⅲ/Ⅳ期患者的 CA125、HE4 和 ROMA 的截断值、敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）。
血清 CA125、HE4 水平和 ROMA 评分随疾病分期进展而显著升高。与 HE4 相比，EOC 患者在同一分期时，ROMA 和 CA125 升高更为频繁。基于 ROC 曲线，FIGO Ⅲ/Ⅳ期 EOC 的截断值分别为 CA125、HE4、绝经前和绝经后 ROMA 的 110IU/mL、126pmol/L、78%和 68%。ROMA 是预测 FIGO 分期的最强指标，具有最高的特异性、准确性和 PPV，绝经后患者分别为 84.4%、82.5%和 87.0%，绝经前患者分别为 89.3%、85.6%和 74.3%。
本研究数据表明，术前卵巢癌患者 ROMA 评分较高与卵巢癌晚期相关。这些观察结果表明，ROMA 在 EOC 患者的综合术前评估中具有潜在的应用价值。
