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Comparison of the risk of ovarian malignancy algorithm and Copenhagen Index for the preoperative assessment of Japanese women with ovarian tumors

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JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 2023年第11期49卷 2717-2727页

作者： Iizuka, Makoto Hamada, Yoshinobu Matsushima, Jun Ichikawa, Teppei Irie, Taichi Yamaguchi, Noriko Sakamoto, Shuichi Ban, Shinichi Takakura, Satoshi Dokkyo Med Univ Dept Obstet & Gynecol Saitama Med Ctr Koshigaya Japan Dokkyo Med Univ Ctr Genet Counseling Saitama Med Ctr Koshigaya Japan Dokkyo Med Univ Dept Pathol Saitama Med Ctr Koshigaya Japan Dokkyo Med Univ Dept Obstet & Gynecol Saitama Med Ctr 2-1-50 Minami Koshigaya Koshigaya Saitama 3438555 Japan

Objective: To compare the risk of ovarian malignancy algorithm (ROMA) and Copenhagen Index (CPH-I) in their ability to distinguish epithelial ovarian cancer (EOC) and malignant ovarian tumors (MLOT) from benign ovarian tumors (BeOT) in Japanese ***: Patients with pathologically diagnosed ovarian tumors were included in this study. The study validated the diagnostic performance of ROMA and ***: Among the 463 Japanese women included in this study, 312 had BeOT, 99 had EOC, and 52 had other MLOT. The receiver-operator characteristic (ROC) area under the curve (AUCs) of ROMA (0.89) and CPH-I (0.89) for distinguishing EOC from BeOT were significantly higher than that of CA125 (0.82) (CA 125 vs. ROMA;p = 0.002, vs. CPH-I;p < 0.001). The ROC-AUCs of ROMA (0.82) and CPH-I (0.81) for distinguishing MLOT from BeOT were significantly higher than that of CA125 (0.75) (CA 125 vs. ROMA: p = 0.003, vs. CPH-I: p < 0.001). The sensitivity (SN)/specificity (SP) of ROMA and CPH-I for distinguishing EOC from BeOT at standard cut-off points were 69%/90%, and 69%/90%, respectively, those for distinguishing MLOT from BeOT were 54%/90%, and 55%/90%, ***: ROMA and CPH-I performed comparably well and better than CA125 in distinguishing EOC from BeOT in Japanese women. ROMA and CHP-I should be used with caution in practical situations, where all histological possibilities for must be considered, because the SNs of ROMA and CPH-I were only 54% and 55%.

关键词： cancer antigen 125 Copenhagen Index human epididymis protein 4 ovarian cancer risk of ovarian malignancy algorithm

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A combined strategy of TK1, HE4 and CA125 shows better diagnostic performance than risk of ovarian malignancy algorithm (ROMA) in ovarian carcinoma

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CLINICA CHIMICA ACTA 2022年 524卷 43-50页

作者： Zhu, Cheng Zhang, Nenghua Zhong, Ailing Xiao, Kangjia Lu, Renquan Guo, Lin Fudan Univ Dept Clin Lab Shanghai Canc Ctr Shanghai Peoples R China Jiaxing Hosp Tradit Chinese Med Dept Clin Lab Municipal Key Innovat Discipline Mol Diagnost Jiaxing Peoples R China Fudan Univ Shanghai Med Coll Dept Oncol Shanghai Peoples R China Fudan Univ Shanghai Canc Ctr Shanghai Med Coll Dept Clin LabDept Oncol 270 Dongan Rd Shanghai 200032 Peoples R China

Background: The dual marker algorithm risk of ovarian malignancy algorithm (ROMA) has been widely used in the clinic for the identification of equivocal pelvic masses in ovarian carcinoma. To obtain higher diagnostic efficiency, we created a new diagnostic index, risk of ovarian malignancy Index (ROMI), by combing thymidine kinase 1 (TK1), HE4 and CA125.& nbsp;Methods: 335 patients with pelvic masses on imaging and 46 healthy controls were enrolled. Serum TK1 was analyzed before further study. ROMI and ROMA were evaluated for diagnostic efficiency.& nbsp;Results: The level of TK1 was elevated in malignant ovarian tumors compared to benign masses (p < 0.001) and healthy controls (p < 0.001). TK1 expression was positively correlated with stage, intrapelvic metastasis, lymphatic metastasis and distant metastasis (all p values < 0.001). The area under the receiver operating characteristic curve (AUC) of ROMI was higher than that of ROMA for both pre-and postmenopausal women. ROMI had better sensitivity, specificity, accuracy, and positive and negative predictive values than ROMA in diagnosis of all-stage or stage I + II ovarian carcinoma for both pre-and postmenopausal women.& nbsp;Conclusions: TK1 is a potential biomarker in detection of ovarian carcinoma. ROMI shows better diagnostic performance than ROMA in distinguishing malignant ovarian tumors from benign masses.

关键词： ovarian cancer algorithm Thymidine kinase 1 risk of ovarian malignancy Index risk of ovarian malignancy algorithm Tumor markers

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A combined strategy of TK1, HE4 and CA125 shows better diagnostic performance than risk of ovarian malignancy algorithm(ROMA) in ovarian carcinoma

A combined strategy of TK1, HE4 and CA125 shows better diagn...

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2021年中国肿瘤标志物学术大会暨第十五届肿瘤标志物青年科学家论坛

作者： Cheng Zhu Lin Guo Renquan Lu Ailing Zhong Kangjia Xiao Fudan University Shanghai Cancer Center

Background: The dual marker algorithm risk of ovarian malignancy algorithm(ROMA) has been widely used in the clinic for identification of equivocal pelvic masses in ovarian carcinoma. To obtain higher diagnostic efficiency, we created a new diagnostic index risk of ovarian malignancy Index(ROMI) by combing thymidine kinase 1(TK1), HE4 and ***: 335 patients with pelvic masses on imaging and 46 healthy controls were enrolled. Serum TK1 was analyzed before further study. ROMI and ROMA were evaluated for diagnostic ***: The level of TK1 was elevated in malignant ovarian tumors compared to benign masses(P<0.001)and healthy controls(P<0.001). TK1 was positively correlated with stage, intrapelvic metastasis,lymphatic metastasis and distant metastasis(all P values <0.001). The area under the receiver operating characteristic curve(AUC) of ROMI was higher than that of ROMA for both pre-and postmenopausal women. ROMI had better sensitivity, specificity, accuracy, positive and negative predictive values than ROMA in diagnosis of all-stage or stage I+Ⅱ ovarian carcinoma for both preand postmenopausal ***: TK1 is a potential biomarker in detection of ovarian carcinoma. ROMI shows better diagnostic performance than ROMA in distinguishing malignant ovarian tumors from benign masses.

关键词： ovarian cancer algorithm Thymidine kinase 1 risk of ovarian malignancy Index risk of ovarian malignancy algorithm Tumor markers

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Falsely elevated human epididymis protein 4 results and risk of ovarian malignancy algorithm in polymorbid women after solid organ transplantation: A pilot and case-control study

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JOURNAL OF CLINICAL LABORATORY ANALYSIS 2018年第6期32卷 e22432-e22432页

作者： Franekova, Janka Cindr, Josef Lavrikova, Petra Komrskova, Jitka Secnik, Peter, Jr. Lanska, Vera Jabor, Antonin Inst Clin & Expt Med Dept Lab Methods Prague Czech Republic Charles Univ Prague Fac Med 3 Prague Czech Republic Inst Clin & Expt Med Gynecol Outpatient Dept Prague Czech Republic Inst Clin & Expt Med Dept Biostat Prague Czech Republic

BackgroundCancer prevention is essential after transplantation (Tx). The use of HE4 and risk of ovarian malignancy algorithm (ROMA) is recommended as a tool for selective ovarian cancer screening;however, creatinine is a known confounder. This study assessed the reliability of HE4, CA125, and ROMA after Tx. MethodsWe matched a total of 202 women without gynecological malignancies and 236 men by age and serum creatinine. Each pair consisted of a patient after Tx (kidney, liver, heart, and pancreas) and a diseased but non-Tx consecutive patient. Serum HE4, CA125 (Roche Cobas 6000), and creatinine (enzymatic, Abbott Architect) were measured in all patients. ResultsCreatinine correlated with HE4 (women: r=.864, P<.0001;men: r=.848, P<.0001). Age correlated slightly with HE4 in women (r=.250, P<.005) and men (r=.240, P<.0005). HE4 in women after Tx (median of 84.8pmol/L) was significantly higher than non-Tx women (53.7pmol/L, P<.0001) in the reference range of serum creatinine. Neither HE4 nor CA125 correlated with tacrolimus concentration, but anemia, hyperparathyroidism, kidney, liver, and lung diseases were possible confounders for HE4 after transplantation (P<.05). ConclusionHuman epididymis protein 4 (HE4) was significantly increased in women after solid organ transplantation compared to levels without transplants matched by age and serum creatinine. HE4 results may be misleading in these patients.

关键词： CA125 creatinine human epididymis protein 4 risk of ovarian malignancy algorithm transplantation

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Ultrasound-based ADNEX model for differentiating between benign, borderline, and malignant epithelial ovarian tumours

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CLINICAL RADIOLOGY 2025年 81卷 106761-106761页

作者： Xie, W. Zhang, Q. Wang, Y. Xiang, Z. Zeng, P. Huo, R. Du, Z. Tang, Lina Fujian Med Univ Fujian Canc Hosp Clin Oncol Sch Dept Ultrasound Fuzhou 350014 Fujian Peoples R China Fujian Med Univ Fujian Canc Hosp Clin Oncol Sch Dept Epidemiol Fuzhou 350014 Fujian Peoples R China Fujian Med Univ Fujian Canc Hosp Clin Oncol Sch Dept Clin Lab Fuzhou 350014 Fujian Peoples R China

BACKGROUND: The purpose of this study was to evaluate the ability of the International ovarian Tumor Analysis-Assessment of Different NEoplasias in the adneXa (IOTA-ADNEX) model to distinguish among benign, borderline, and malignant epithelial ovarian tumours (BeEOTs, BEOTs, and MEOTs, respectively). METHODS: The study included 813 patients with BeEOTs, BEOTs, and MEOTs who underwent ultrasound examinations and pelvic operations. Comparisons were made between the clinical information and ultrasonographic features of the three patient groups, and the histopathological diagnosis was the gold standard. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) of the ADNEX model were calculated. RESULTS: This was a single-centre retrospective study. Of the 813 patients, 257 (31.6%) had BeEOTs, 114 (14.0%) had BEOTs, and 442 (54.4%) had MEOTs. For a cut-off value of 10% to identify the overall risk for ovarian cancer (OC), the sensitivity and specificity were 99.1% and 73.2%, respectively. According to the receiver operating characteristicscurves, the AUC was 0.987 (95% CI: 0.981-0.993) for BeEOTs compared with MEOTs, 0.820 (95% CI: 0.768-0.872) for BeEOTs compared with BEOTs, 0.912 (95% CI: 0.876-0.948) for BeEOTs compared with stage I OC, and 0.995 (95% CI: 0.992-0.998) for BeEOTs compared with stages II-IV OC. The AUC was 0.614(95% CI: 0.519-0.709) for BEOTs compared with stage I OC, 0.903 (95% CI: 0.869-0.937) for BEOTs compared with stages II-IV OC, and 0.851 (95% CI: 0.80 0-0.902) for stage I OC compared with stages II-IV OC. CONCLUSIONS: The IOTA-ADNEX model demonstrated good diagnostic performance for the three categories of EOTs and may have the potential to be popularised in assisting radiologists in the assessment of adnexal masses in the future. (c) 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights are reserved, including those for text and d

关键词： EOTs Epithelial ovarian tumours MEOTs Malignant epithelial ovarian tumours BeEOTs benign epithelial ovarian tumours BEOTs borderline epithelial ovarian tumours IOTA International ovarian Tumor Analysis ADNEX Assessment of Different NEoplasias in the adneXa CA125 Carbohydrate antigen125 HE4 Human Epididymis Protein 4 ROMA risk of ovarian malignancy algorithm ROC Receiver operating characteristics AUC Area under the receiver operating characteristics curve ISUOG International Society for Ultrasound in Obstetrics and Gynecology ESGO European Society for Gynaecological Oncology ESGE European Society for Gynaecological Endoscopy

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Value of the Copenhagen index in the diagnosis of malignant adnexal tumors: A meta-analysis

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INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS 2023年第2期160卷 506-515页

作者： Yue, Xiang Yue, Zhenni Wang, Ying Dong, Zhenjin Yang, Hua Yue, Sifeng Jilin Univ Bethune Clin Med Coll 2 Changchun Peoples R China Guilin Med Univ Dept Gynecol Affiliated Hosp 2 Guilin Peoples R China Henan Univ Sch Clin Med Kaifeng Peoples R China Guilin Med Coll Dept Neonatal Pediat Affiliated Hosp Guilin 541001 Peoples R China

ovarian cancer is a common gynecological malignant tumor. Early diagnosis is important for the prognosis of patients with ovarian cancer. To evaluate the accuracy of the Copenhagen Index (CPH-I) in detecting malignant adnexal tumors and to compare the diagnostic accuracy of CPH-I and the risk of ovarian malignancy algorithm (ROMA). PubMed, Web of Science, and Cochrane Library databases were used to retrieve eligible studies. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the (summary receiver operating characteristic) curve (AUC) were 0.81, 0.88, 6.61, 0.22, 30.43, and 0.91, respectively, in diagnosing malignant adnexal tumors. In addition, using ROMA, the sensitivity, specificity, and AUC were 0.83, 0.85, and 0.90, respectively. CPH-I showed high accuracy in diagnosing malignant adnexal tumors, which could be an alternative method with similar efficacy to ROMA. CPH-I was more advantageous in diagnosing adnexal tumors in postmenopausal women.

关键词： adnexal tumors Copenhagen index diagnosis meta-analysis risk of ovarian malignancy algorithm

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Diagnostic performance of CA125, HE4, ROMA, and CPH-I in identifying primary ovarian cancer

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JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH 2023年第3期49卷 998-1006页

作者： Luo, Hui-Jing Hu, Zhi-Dong Cui, Ming Zhang, Xiao-Fang Tian, Wen-Yan Ma, Chao-Qun Ren, Ya-Nv Dong, Zuo-Liang Tianjin Med Univ Gen Hosp Dept Clin Lab Ctr Tianjin Peoples R China Chinese Acad Med Sci & Peking Union Med Coll Inst Radiat Med Tianjin Key Lab Radiat Med & Mol Nucl Med Tianjin Peoples R China Tianjin Med Univ Gen Hosp Dept Obstet & Gynecol Tianjin Peoples R China Tianjin Med Univ Gen Hosp 154 Anshan St Tianjin 300052 Peoples R China

Aims: To evaluate the ability of carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4), risk of ovarian malignancy algorithm (ROMA), and Copenhagen Index (CPH-I) to identify primary ovarian cancer (OC) from border-line and benign ovarian tumors (OTs) and explore ideal cutoff ***: A total of 684 OTs containing 276 OC patients, 116 ovarian borderline OTs and 292 benign OTs patients who underwent surgery in our hospital were included. We retrospectively searched the results of CA125 and HE4 before patients' surgery from the hospital's electronic medical records system. ROMA and CPH-I were calculated according to their menopausal status and age, respectively. Diagnostic performance of these four were assessed by drawing receiver operating characteristic (ROC) ***: CA125, HE4, ROMA, and CPH-I were all significantly higher in OC women compared with borderline OTs (p < 0.001), followed by benign OTs (p < 0.001). Area under the curves (AUCs) for distinguishing OC were 0.850 (0.818-0.882), 0.891 (0.865-0.916), 0.910 (0.888-0.933) and 0.906 (0.882-0.930), respectively, and the corresponding ideal cutoff values for CA125, HE4, ROMA, and CPH-I were 132.5, 68.6, 23.8, and 6.4, respectively. The difference between ROMA and CPH-I was not significant (p = 0.97), but both were higher than CA125 and HE4 (p < 0.05). HE4 showed a significantly higher AUC than CA125 (p < 0.05). For postmenopausal women, CA125 performed equivalently to ROMA (p = 0.73) and CPH-I (p = 0.91).Conclusions: In identifying patients with OC, ROMA and CPH-I outperformed single tumor marker. The diagnostic performance of HE4 was significantly higher than that of CA125. CA125 was more suitable for postmenopausal women.

关键词： carbohydrate antigen 125 Copenhagen index human epididymis protein 4 ovarian cancer risk of ovarian malignancy algorithm

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Subjective assessment by ultrasound is superior to the risk of malignancy index (RMI) or the risk of ovarian malignancy algorithm (ROMA) in discriminating benign from malignant adnexal masses

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EUROPEAN JOURNAL OF CANCER 2012年第11期48卷 1649-1656页

作者： Van Gorp, Toon Veldman, Joan Van Calster, Ben Cadron, Isabelle Leunen, Karin Amant, Frederic Timmerman, Dirk Vergote, Ignace Maastricht Univ Med Ctr GROW Sch Oncol & Dev Biol Div Gynaecol OncolDept Obstet & Gynaecol NL-6202 AZ Maastricht Netherlands Katholieke Univ Leuven Univ Ziekenhuizen Leuven Leuven Canc Inst Dept Obstet & Gynaecol B-3000 Louvain Belgium Virga Jesse Ziekenhuis Dept Obstet & Gynaecol B-3500 Hasselt Belgium AZ Turnhout Dept Obstet & Gynaecol B-2300 Turnhout Belgium

Purpose: The combination of two tumour markers, CA125 and HE4, in the risk of ovarian malignancy assay (ROMA) has been shown to be successful in classifying patients into those who have a high or low risk of epithelial ovarian cancer. In the present study, the diagnostic accuracy of ROMA was assessed and compared to the diagnostic accuracy of the two most widely used ultrasound methods, namely the risk of malignancy index (RMI) and subjective assessment by ultrasound. Methods: From August, 2005 to March, 2009, 432 women with a pelvic mass who were scheduled to have surgery were enrolled in a single-centre prospective cohort study. A preoperative ultrasound was performed and preoperative CA125 and HE4 serum levels were measured. Once the final surgical pathology reports were obtained, the diagnostic accuracy and performance indices of ROMA, RMI and subjective assessment were calculated. Results: Of the 432 eligible patients, 374 could be analysed. Subjective assessment had the highest area under the receiver operator characteristic curve (AUC) (0.968, 95% CI: 0.945-0.984), followed by the RMI(0.931, 95% CI: 0.901-0.955). The subjective assessment and RMI both had significantly higher AUCs than the ROMA (0.893, 95% CI: 0.857-0.922;P < 0.0001 and P = 0.0030, respectively). The pre- and postmenopausal populations generated similar results. Conclusion: Although new tumour markers models are promising, they do not contribute significantly to the diagnosis of ovarian cancer. Ultrasound, especially subjective assessment by ultrasound, remains superior in discriminating malignant from benign ovarian masses. (C) 2011 Elsevier Ltd. All rights reserved.

关键词： HE4 CA125 Ultrasound ovarian neoplasm risk of malignancy index Subjective assessment risk of ovarian malignancy algorithm Sensitivity and specificity

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Ultrasound Features Improve Diagnostic Performance of ovarian Cancer Predictors in Distinguishing Benign and Malignant ovarian Tumors

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Current Medical Science 2020年第1期40卷 184-191页

作者： Yong-ning CHEN Fei MA Ya-di ZHANG Li CHEN Chan-yuan LI Shi-peng GONG Department of Gynecology The First Affiliated Hospital of Jinan UniversityGuangzhou 510632China Department of Obstetrics and Gynecology Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China Department of Ultrasonography Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China Department of PET Center Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China

To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from September 2014 to November ***,menopausal status,histopathology,the International Federation of Gynecology and Obstetrics(FIGO)stages,tumor biomarker levels,and detailed ultrasound reports of patients were *** area under the curve(AUC),sensitivity,and specificity of the bellow-mentioned predictors were analyzed using the receiver operating characteristic *** the 719 patients,531 had benign lesions,119 had epithelial ovarian cancers(EOC),44 had borderline ovarian tumors(BOT),and 25 had *** and the sensitivity of cancer antigen 125(CAI25),human epididymis-specific protein 4(HE4),risk of ovarian malignancy algorithm(ROMA),risk of malignancy Index(RMI1),HE4 model,and Rajavithi-ovarian Cancer Predictive Score(R-OPS)in the overall population were 0.792,0.854,0.856,0.872,0.893,0.852,and 70.2%,56.9%,69.1%,60.6%,77.1%,71.3%,*** distinguishing EOC from benign tumors,the AUCs and sensitivity of the above mentioned predictors were 0.888,0.946,0.947,0.949,0.967,0.966,and 84.0%,79.8%,87.4%,84.9%,90.8%,89.1%,*** specificity in predicting benign diseases was 72.9%,94.4%,87.6%,95.9%,86.3%,90.8%,***,we consider biomarkers in combination with ultrasound features may improve the diagnostic performance in distinguishing malignant from benign ovarian tumors.

关键词： cancer antigen 125 human epididymis-specific protein 4 risk of ovarian malignancy algorithm risk of malignancy Index risk of malignancy Index model Rajavithi-ovarian Cancer Predictive Score ovarian masses

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HE4 and CA125 as a diagnostic test in ovarian cancer: prospective validation of the risk of ovarian malignancy algorithm

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BRITISH JOURNAL OF CANCER 2011年第5期104卷 863-870页

作者： Van Gorp, T. Cadron, I. Despierre, E. Daemen, A. Leunen, K. Amant, F. Timmerman, D. De Moor, B. Vergote, I. Katholieke Univ Leuven Univ Ziekenhuizen Leuven Dept Obstet & Gynaecol Div Gynaecol Oncol B-3000 Leuven Belgium MUMC GROW Sch Oncol & Dev Biol Dept Obstet & Gynaecol Div Gynaecol Oncol NL-6202AZ Maastricht Netherlands Katholieke Univ Leuven ESAT SCD SISTA Dept Elect Engn B-3001 Leuven Belgium

BACKGROUND: Recently, a risk of ovarian malignancy algorithm (ROMA) utilising human epididymis secretory protein 4 (HE4) and CA125 successfully classified patients as presenting a high or low risk for epithelial ovarian cancer (EOC). We validated this algorithm in an independent prospective study. METHODS: Women with a pelvic mass, who were scheduled to have surgery, were enrolled in a prospective study. Preoperative serum levels of HE4 and CA125 were measured in 389 patients. The performance of each of the markers, as well as that of ROMA, was analysed. RESULTS: When all malignant tumours were included, ROMA (receiver operator characteristic (ROC)-area under curve (AUC) = 0.898) and HE4 (ROC-AUC) = 0.857) did not perform significantly better than CA125 alone (ROC-AUC = 0.877). Using a cutoff for ROMA of 12.5% for pre-menopausal patients, the test had a sensitivity of 67.5% and a specificity of 87.9%. With a cutoff of 14.4% for post-menopausal patients, the test had a sensitivity of 90.8% and a specificity of 66.3%. For EOC vs benign disease, the ROC-AUC of ROMA increased to 0.913 and for invasive EOC vs benign disease to 0.957. CONCLUSION: This independent validation study demonstrated similar performance indices to those recently published. However, in this study, HE4 and ROMA did not increase the detection of malignant disease compared with CA125 alone. Although the initial reports were promising, measurement of HE4 serum levels does not contribute to the diagnosis of ovarian cancer. British Journal of Cancer (2011) 104, 863-870. doi:10.1038/***.6606092 *** Published online 8 February 2011 (C) 2011 Cancer Research UK

关键词： HE4 CA125 ovarian cancer risk of ovarian malignancy algorithm

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