The performance of Carbohydrate Antigen 125-Thomsen-nouveau and anti-Müllerian hormone combined with CA125, Human epididymis protein 4 and Risk of Malignancy Algorithm in diagnosis for patients with Epithelial ovarian cancer

• Published in: Clinical biochemistry Vol. 119; p. 110615
• Main Authors: Hou, Xiuzhu, Liu, Shanshan, Liu, Jing, Zhou, Jiansuo, Liang, Yongming, Cui, Liyan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2023
• Subjects: Anti-Müllerian hormone; Carbohydrate Antigen 125; Carbohydrate Antigen 125-Thomsen-nouveau; Epithelial ovarian cancer; Human epididymis protein 4; Risk of Malignancy Algorithm; Carbohydrate Antigen 125; BOT; CI; ROC; CCO; AUC; BET; Anti-Müllerian hormone; Human epididymis protein 4; Epithelial ovarian cancer; HE4; ROMA; EOC; CA125; Carbohydrate Antigen 125-Thomsen-nouveau; Tn; Spearman r; HC; AMH; Risk of Malignancy Algorithm; DC
• DOI: 10.1016/j.clinbiochem.2023.110615
• ISSN: 0009-9120; 1873-2933

•CA125-Tn and AMH can be treated as valuable biomarkers of Epithelial ovarian cancer.•ROMA was positively correlated with CA125-Tn and negatively correlated with AMH.•Combined with CA125, HE4 and ROMA, CA125-Tn and AMH are more conducive to the diagnosis of epithelial ovarian cancer. We examined the blood concentrations of Carbohydrate Antigen 125-Thomsen-nouveau (CA125-Tn) and anti-Müllerian hormone (AMH) in epithelial ovarian cancer (EOC) patients to evaluate their potential diagnostic utility together with CA125, human epididymis protein 4 (HE4) and Risk of Malignancy Algorithm (ROMA). 50 healthy subjects, 45 EOC patients, 22 patients with borderline ovarian tumors (BOT), 21 patients with benign ovarian tumor (BET) and 45 patients with chocolate cyst of ovary (CCO) were studied. Blood levels of CA125, HE4, CA125-Tn and AMH were measured, and the ROMA value was calculated. We compared the differences in the levels of these biomarkers among groups. Additionally, a total of 10 testing strategies were established for comparison to maximize the diagnostic value. The levels of CA125, HE4, CA125-Tn and ROMA value were significantly higher in EOC group compared with either the disease control (DC) group (BOT group, BET group and CCO group) or healthy control (HC) group (p < 0.001). In addition, they had better discriminatory performance with an area under the receiver operator characteristic curve (AUC) 0.93; 0.93; 0.93; 0.85, respectively (p < 0.001) compared with the AUC value of AMH 0.67 (p < 0.001). Among all 10 testing strategies, both single-positive of ROMA and double-positive of any 2 markers showed better Youden index (0.82, 0.79, respectively) and kappa value (κ) (0.82, 0.81, respectively). CA125-Tn and AMH can be treated as useful biomarkers of EOC when combined with CA125, HE4 and ROMA, because when any two biomarkers of them are positive, the value of EOC diagnosis is maximized.