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Original Research

Open Access

Using HE4, RMI, ROMA and CPH-I in the differential diagnosis of adnexal masses

  • Zhen Shen1,2
  • Chen-Chen Zhu3
  • Li-Li Qian2
  • Tian-Jiao Zhang2
  • Min Li2
  • Jing Zhu2
  • Da-Bao Wu2
  • Ying Zhou2
  • Xing-Sheng Yang1,*,

1Department of Gynecology and Obstetrics, Qilu Hospital Affiliated to Shandong University, Jinan, 250012 Shandong, P. R. China

2Department of Obstetrics and Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui, P. R. China

3Anhui Medical University, Anhui Provincial Hospital, Hefei, 230001 Anhui, P. R. China

DOI: 10.31083/j.ejgo.2021.01.2192 Vol.42,Issue 1,February 2021 pp.139-147

Submitted: 09 July 2020 Accepted: 20 August 2020

Published: 15 February 2021

*Corresponding Author(s): Xing-Sheng Yang E-mail: yxssddx@outlook.com

Abstract

Objectives: In order to improve the early diagnosis of ovarian cancer (OC), we evaluated human epididymis secretory protein 4 (HE4), the risk of malignancy index (RMI), the risk of ovarian malignancy algorithm (ROMA), and the Copenhagen Index (CPH-I) in their ability to predict the risk of adnexal masses being malignant, and in discriminating between serous and mucinous ovarian tumors. Methods: A study consisting of 509 patients who were diagnosed with benign, borderline, and malignant adnexal tumors was conducted. We analyzed the values of HE4, RMI, ROMA, and CPH-I. In addition, CA125, CEA, CA125/CEA ratio, CA199, and CA125/CA199 ratio were also assessed to determine their predictive values to diagnoses serous or mucinous ovarian tumors. Results: To differentiate between benign and borderline ovarian tumors, we evaluated RMI and CPH-I scores which showed high AUC (0.7593, and 0.7128, respectively), but neither of them showed both high sensitivity and specificity. When discriminating benign and malignant tumors, RMI and CPH-I performed the best for premenopausal women; whereas ROMA and HE4 performed the best for postmenopausal women. Patients with values above the cutoff for CA125 (> 328.3 U/mL), CA125/CEA (> 82.26), and CA125/CA199 (> 5.633), were more likely to be diagnosed with serous carcinoma. Whereas those with higher values for CEA (> 3.7 μμg/L) and CA199 (> 27.81 ng/mL) were more likely to have a mucinous carcinoma. Conclusion: RMI and CPH-I for premenopausal women, ROMA and RMI for postmenopausal women were reliable indicators to differentiate between women with benign versus malignant tumors. In addition, the ratios CA125/CEA and CA125/CA199 could be used to distinguish serous from mucinous ovarian carcinomas.


Keywords

CPH-I; HE4; Ovarian tumors; RMI; ROMA


Cite and Share

Zhen Shen,Chen-Chen Zhu,Li-Li Qian,Tian-Jiao Zhang,Min Li,Jing Zhu,Da-Bao Wu,Ying Zhou,Xing-Sheng Yang. Using HE4, RMI, ROMA and CPH-I in the differential diagnosis of adnexal masses. European Journal of Gynaecological Oncology. 2021. 42(1);139-147.

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