Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen Street, Hue 491200, Viet Nam.
Department of Obstetrics and Gynecology, Nuvance Health, University of Vermont Larner College of Medicine, Burlington, VT 05405, United States.
Gynecol Oncol. 2021 Jul;162(1):113-119. doi: 10.1016/j.ygyno.2021.05.001. Epub 2021 May 14.
This study aimed to evaluate the diagnostic performances of the Copenhagen Index (CPH-I) and Risk of Ovarian Malignancy Algorithm (ROMA) in the preoperative prediction of ovarian cancer.
In a prospective cohort study, data were collected from 475 patients with ovarian masses diagnosed by gynecologic examination / ultrasound who were hospitalized at the Departments of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital, Vietnam, between January 2018 and June 2020. ROMA and CPH-I were calculated based on measurements of serum carbohydrate antigen (CA-125) and human epididymis protein (HE4). The final diagnosis was based on clinical features, radiologic and histologic findings, and the International Federation of Gynecology and Obstetrics (FIGO) 2014 stages of ovarian cancer were recorded. Matching the values of ROMA and CPH-I to postoperative histopathology reports resulted in the preoperative prediction values.
Among the 475 women, 408 had benign tumors, 5 had borderline tumors and 62 had malignant tumors. The two indices showed similar discriminatory performances with no significant differences (p > 0.05). At an optimal cut-off, the sensitivities/specificities of ROMA and CPH-I for ovarian cancer diagnosis were 74.2% and 91.8%, 87.1% and 78.5%, respectively. The optimal cut-off for CPH-I was 1.89%. The areas under the ROC curves (AUCs) of ROMA and CPH-I were 0.882 (95% CI: 0.849-0.909) and 0.898 (95% CI: 0.867-0.924), respectively.
The introduction of the Copenhagen Index to help stratify the malignancy risk of ovarian tumors, irrespective of menopausal status, might be applied as a simple alternative with a similar efficacy to ROMA in clinical practice.
本研究旨在评估哥本哈根指数（CPH-I）和卵巢恶性肿瘤风险算法（ROMA）在术前预测卵巢癌中的诊断性能。
在一项前瞻性队列研究中，数据来自于 2018 年 1 月至 2020 年 6 月期间在越南顺化医科大学附属医院和顺化中央医院妇产科住院的 475 名经妇科检查/超声诊断为卵巢肿块的患者。ROMA 和 CPH-I 是基于血清糖抗原（CA-125）和人附睾蛋白（HE4）的测量值计算的。最终诊断基于临床特征、影像学和组织学发现以及国际妇产科联合会（FIGO）2014 年卵巢癌分期。将 ROMA 和 CPH-I 的值与术后组织病理学报告相匹配，得出术前预测值。
在 475 名女性中，408 例为良性肿瘤，5 例为交界性肿瘤，62 例为恶性肿瘤。这两个指数的鉴别性能相似，差异无统计学意义（p>0.05）。在最佳截断值时，ROMA 和 CPH-I 对卵巢癌诊断的敏感性/特异性分别为 74.2%和 91.8%、87.1%和 78.5%。CPH-I 的最佳截断值为 1.89%。ROMA 和 CPH-I 的 ROC 曲线下面积（AUC）分别为 0.882（95%CI：0.849-0.909）和 0.898（95%CI：0.867-0.924）。
引入哥本哈根指数有助于分层卵巢肿瘤的恶性风险，不论绝经状态如何，都可以作为一种简单的替代方法，与 ROMA 相比，其在临床实践中的疗效相似。
