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

• Published in: American journal of obstetrics and gynecology Vol. 203; no. 3; pp. 228.e1 - 228.e6
• Main Authors: Moore, Richard G., MD, Jabre-Raughley, Moune, MD, Brown, Amy K., MD, Robison, Katina M., MD, Miller, M. Craig, BS, Allard, W. Jeffery, PhD, Kurman, Robert J., MD, Bast, Robert C., MD, Skates, Steven J., PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2010; Elsevier
• Subjects: Algorithms; beta-Defensins; Biological and medical sciences; Biomarkers, Tumor - blood; CA-125 Antigen - blood; CA125; Diagnostic Imaging; Epididymal Secretory Proteins - analysis; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; HE4; Humans; Lymphatic Metastasis; Medical sciences; Membrane Proteins - blood; Menopause; Neoplasm Staging; Neoplasms, Glandular and Epithelial - diagnosis; Obstetrics and Gynecology; ovarian cancer; Ovarian Neoplasms - diagnosis; pelvic mass; Risk Assessment; ROC Curve; ROMA; Sensitivity and Specificity; Tumors; CA125; ovarian cancer; HE4; pelvic mass; ROMA; Human; Ovary carcinoma; Multiple; Gynecology; Index; Malignancy; Marker; Malignant tumor; Obstetrics; Female genital diseases; Assay; Mass; Ovarian diseases; Pelvic cavity; Risk factor; Predictive factor; Comparative study; Cancer
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.03.043

Objective We sought to compare the Risk of Malignancy Index (RMI) to the Risk of Ovarian Malignancy Algorithm (ROMA) to predict epithelial ovarian cancer (EOC) in women with a pelvic mass. Study Design In all, 457 women with imaging results from ultrasound, computed tomography, magnetic resonance imaging, and serum HE4 and CA125 determined prior to surgery for pelvic mass were evaluable. RMI values were determined using CA125, imaging score, and menopausal status. ROMA values were determined using HE4, CA125, and menopausal status. Results At a set specificity of 75%, ROMA had a sensitivity of 94.3% and RMI had a sensitivity of 84.6% for distinguishing benign status from EOC ( P = .0029). In patients with stage I and II disease, ROMA achieved a sensitivity of 85.3% compared with 64.7% for RMI ( P < .0001). Conclusion The dual marker algorithm utilizing HE4 and CA125 to calculate a ROMA value achieves a significantly higher sensitivity for identifying women with EOC than does RMI.