Behnamfar Fariba, Zafarbakhsh Aazam, Ahmadian Narges
Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2023 Jun 28;12:156. doi: 10.4103/abr.abr_264_22. eCollection 2023.
Evaluation of ovarian tumors based on tumor markers could have high clinical importance. In this study, we aimed to assess the predictive value of HE4 and Risk of Ovarian Malignancy Algorithm (ROMA) compared to CA-125 in the Malignancy of ovarian epithelial masses.
This cross-sectional study was performed in 2020-2021 including 203 patients. Serum HE4 and CA-125 levels were checked before surgery. According to the pathology report (benign, borderline, or malignant epithelial mass), the predictive values of the three markers were evaluated.
About 146 cases were benign; 14 cases were borderline and 43 cases were malignant. Most patients (69.8%) in the malignant group were in stage 3. Significantly higher levels of all three markers (CA-125, HE4, and ROMA) were found in patients with malignant tumors compared to benign or borderline tumors ( < 0.001 for all). The sensitivity of CA-125 was the highest (90.7%) in pre- and post-menopausal patients but the specificity of HE4 and ROMA were higher than CA-125 (98.1% and 97.5%, respectively, versus 86.9% for CA-125). In post-menopausal patients, both sensitivities of HE4 and ROMA were 90.5% and the specificity and sensitivity of CA-125 were the highest (95.2% and 100%). In premenopausal patients, the sensitivity of ROMA (90.9%) and the specificity of HE4 (100%) were the highest.
HE4 and ROMA are not necessary for postmenopausal patients in low-resource areas and a check of serum CA-125 will be enough. The higher-cost, ROMA, and HE4 checks are recommended in premenopausal people because they are more sensitive.
基于肿瘤标志物评估卵巢肿瘤具有较高的临床重要性。在本研究中，我们旨在评估与CA-125相比，人附睾蛋白4（HE4）和卵巢恶性肿瘤风险算法（ROMA）在卵巢上皮性肿块恶性肿瘤中的预测价值。
本横断面研究于2020年至2021年进行，纳入203例患者。术前检测血清HE4和CA-125水平。根据病理报告（良性、交界性或恶性上皮性肿块），评估三种标志物的预测价值。
约146例为良性；14例为交界性，43例为恶性。恶性组大多数患者（69.8%）处于3期。与良性或交界性肿瘤患者相比，恶性肿瘤患者的所有三种标志物（CA-125、HE4和ROMA）水平均显著更高（所有P<0.001）。CA-125在绝经前和绝经后患者中的敏感性最高（90.7%），但HE4和ROMA的特异性高于CA-125（分别为98.1%和97.5%，而CA-125为86.9%）。在绝经后患者中，HE4和ROMA的敏感性均为90.5%，CA-125的特异性和敏感性最高（分别为95.2%和100%）。在绝经前患者中，ROMA的敏感性（90.9%）和HE4的特异性（100%）最高。
在资源匮乏地区，绝经后患者无需检测HE4和ROMA，检测血清CA-125就足够了。由于绝经前人群中ROMA和HE4检测更敏感，建议进行成本更高的ROMA和HE4检测。
