Analysis of falsely elevated risk of ovarian malignancy algorithm in women with ovarian endometrioma
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ObjectiveTo estimate the incidence of falsely elevated risk of ovarian malignancy algorithm (ROMA) in a group of women with pathologically confirmed endometrioma and to investigate the associated factors. MethodsOne hundred premenopausal women surgically diagnosed with ovarian endometrioma were selected. Preoperative clinical, laboratory, and surgical characteristics were compared between the elevated-risk group (ROMA-premenopausal value, ≥7.4%) and normal-risk group (ROMA-premenopausal value, <7.4%). ResultsElevated ROMA was observed in 15 women (false positive rate, 15%). Excluding one woman with known chronic renal failure, we compared the characteristics of 99 women between the elevated-risk group (n=14) and the normal-risk group (n=85). None of the clinical and surgical variables distinguished the two groups. Serum level of CA 125 >82.3 U/mL and serum level of human epididymis protein 4 (HE4) >46 pmol/L could predict an elevated ROMA test with a statistical significance. When serum level of HE4 ≤46 pmol/L, none of the women showed an elevated ROMA test, regardless of serum level of CA 125; however, 55.6% of the women showed an elevated ROMA test when serum level of HE4 >46 pmol/L and CA 125 ≤82.3 U/mL and all women showed an elevated ROMA test when serum level of HE4 >46 pmol/L and CA 125 >82.3 U/mL. ConclusionThe incidence of falsely elevated ROMA was 15% in the group of women with pathologically confirmed endometrioma. Interpretation of the ROMA results should be cautious when serum level of HE4 >46 pmol/L and CA 125 >82.3 U/mL in women with suspicious ovarian endometrioma.
Abstract
ObjectiveTo estimate the incidence of falsely elevated risk of ovarian malignancy algorithm (ROMA) in a group of women with pathologically confirmed endometrioma and to investigate the associated factors. MethodsOne hundred premenopausal women surgically diagnosed with ovarian endometrioma were selected. Preoperative clinical, laboratory, and surgical characteristics were compared between the elevated-risk group (ROMA-premenopausal value, ≥7.4%) and normal-risk group (ROMA-premenopausal value, <7.4%). ResultsElevated ROMA was observed in 15 women (false positive rate, 15%). Excluding one woman with known chronic renal failure, we compared the characteristics of 99 women between the elevated-risk group (n=14) and the normal-risk group (n=85). None of the clinical and surgical variables distinguished the two groups. Serum level of CA 125 >82.3 U/mL and serum level of human epididymis protein 4 (HE4) >46 pmol/L could predict an elevated ROMA test with a statistical significance. When serum level of HE4 ≤46 pmol/L, none of the women showed an elevated ROMA test, regardless of serum level of CA 125; however, 55.6% of the women showed an elevated ROMA test when serum level of HE4 >46 pmol/L and CA 125 ≤82.3 U/mL and all women showed an elevated ROMA test when serum level of HE4 >46 pmol/L and CA 125 >82.3 U/mL. ConclusionThe incidence of falsely elevated ROMA was 15% in the group of women with pathologically confirmed endometrioma. Interpretation of the ROMA results should be cautious when serum level of HE4 >46 pmol/L and CA 125 >82.3 U/mL in women with suspicious ovarian endometrioma.
참고문헌 (12)
- Moore RG, "The use of multiple novel tumor biomarkers for the detection of ovarian carcinoma in patients with a pelvic mass", Gynecol Oncol, 108, pp.402~408 (2008)
- Moore RG, "A novel multiple marker bioassay utilizing HE4 and CA125 for the prediction of ovarian cancer in patients with a pelvic mass", Gynecol Oncol, 112, pp.40~46 (2009)
- Moore RG, "Comparison of a novel multiple marker assay vs the Risk of Malignancy Index for the prediction of epithelial ovarian cancer in patients with a pelvic mass", Am J Obstet Gynecol, 203, pp.228.e1~228.e6 (2010)
- Jacob F, "No benefit from combining HE4 and CA125 as ovarian tumor markers in a clinical setting", Gynecol Oncol, 121, pp.487~491 (2011)
- Stukan M, "Usefulness of diagnostic indices comprising clinical, sonographic, and biomarker data for discriminating benign from malignant ovarian masses", J Ultrasound Med, 34, pp.207~217 (2015)
- Karolina Partheen, "Evaluation of ovarian cancer biomarkers HE4 and CA-125 in women presenting with a suspicious cystic ovarian mass", Journal of Gynecologic Oncology, 22(4), pp.244~252 (2011), 대한부인종양학회
- Van Gorp T, "HE4 and CA125 as a diagnostic test in ovarian cancer : prospective validation of the risk of ovarian malignancy algorithm", Br J Cancer, 104, pp.863~870 (2011)
- Karlsen MA, "Evaluation of HE4, CA125, risk of ovarian malignancy algorithm (ROMA) and risk of malignancy index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass", Gynecol Oncol, 127, pp.379~383 (2012)
- Lin J, "Human epididymis protein 4 for differential diagnosis between benign gynecologic disease and ovarian cancer: a systematic review and metaanalysis", Eur J Obstet Gynecol Reprod Biol, 167, pp.81~85 (2013)
- Romeo V, "Is HE4 serum level a valid screening test in women candidates for kidney transplant? A case report and a review of literature", Clin Ter, 165, pp.e162~e165 (2014)
- Li PL, "Combined detection of sialic acid and hydroxyproline in diagnosis of ovarian cancer and its comparison with human epididymis protein 4 and carbohydrate antigen 125", Clin Chim Acta, 439, pp.148~153 (2015)
- Granato T, "HE4 in the differential diagnosis of ovarian masses", Clin Chim Acta, 446, pp.147~155 (2015)