Discriminative value of CA-125, HE4, Risk of Malignancy Index II (RMI-II) and Risk of Malignancy Algorithm (ROMA) in the differential diagnosis of pelvic masses: conclusions from a referral Centre in Portugal

Melo, Adriana; Veríssimo, Renata; Farinha, Margarida; Martins, Nuno Nogueira; Martins, Francisco Nogueira

doi:10.1080/01443615.2018.1457632

Cited by 11 publications

(13 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1 ) shows the stages of the studies screened and included for the analysis, and 32 studies 15 – 46 met the inclusion criteria. The number of studies included for HE4, CA125 and ROMA tests were 25 16 – 19 , 22 – 32 , 34 , 35 , 37 – 43 , 26 16 – 20 , 22 – 35 , 37 – 41 , 43 and 22 15 – 18 , 20 , 21 , 26 – 29 , 31 , 34 – 43 , 46 , respectively. The patients with EOC were taken as cases, and women with benign ovarian mass were taken as control, which was 2233/5682, 2315/5875 and 2281/5068, respectively, for the markers or algorithm (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Diagnostic measures comparison for ovarian malignancy risk in Epithelial ovarian cancer patients: a meta-analysis

Suri

Vanamail

Ammalli

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Epithelial ovarian cancer has become the most frequent cause of deaths among gynecologic malignancies. Our study elucidates the diagnostic performance of Risk of Ovarian Malignancy Algorithm (ROMA), Human epididymis secretory protein 4 (HE4) and cancer antigen (CA125). To compare the diagnostic accuracy of ROMA, HE-4 and CA125 in the early diagnosis and screening of Epithelial Ovarian Cancer. Literature search in electronic databases such as Medicine: MEDLINE (through PUBMED interface), EMBASE, Google Scholar, Science Direct and Cochrane library from January 2011 to August 2020. Studies that evaluated the diagnostic measures of ROMA, HE4 and CA125 by using Chemilumincence immunoassay or electrochemiluminescence immunoassay (CLIA or ECLIA) as index tests. Using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). We included 32 studies in our meta-analysis. We calculated AUC by SROC, pooled estimated like sensitivity, specificity, likelihood ratio, diagnostic odds ratio (DOR), Tau square, Cochran Q through random effect analysis and meta-regression. Data was retrieved from 32 studies. The number of studies included for HE4, CA125 and ROMA tests was 25, 26 and 22 respectively. The patients with EOC were taken as cases, and women with benign ovarian mass were taken as control, which was 2233/5682, 2315/5875 and 2281/5068 respectively for the markers or algorithm. The pooled estimates of the markers or algorithm were sensitivity: ROMA (postmenopausal) (0.88, 95% CI 0.86–0.89) > ROMA (premenopausal) 0.80, 95% CI 0.78–0.83 > CA-125(0.84, 95% CI 0.82–0.85) > HE4 (0.73, 95% CI 0.71–0.75) specificity: HE4 (0.90, 95% CI 0.89–0.91) > ROMA (postmenopausal) (0.83, 95% CI 0.81–0.84) > ROMA (premenopausal) (0.80, 95% CI 0.79–0.82) > CA125 (0.73, 95%CI 0.72–0.74), Diagnostic odd’s ratio ROMA (postmenopausal) 44.04, 95% CI 31.27–62.03, ROMA (premenopausal)-18.93, 95% CI 13.04–27.48, CA-125-13.44, 95% CI 9.97–18.13, HE4-41.03, 95% CI 27.96–60.21 AUC(SE): ROMA (postmenopausal) 0.94(0.01), ROMA (premenopausal)-0.88(0.01), HE4 0.91(0.01), CA125-0.86(0.02) through bivariate random effects model considering the heterogeneity. Our study found ROMA as the best marker to differentiate EOC from benign ovarian masses with greater diagnostic accuracy as compared to HE4 and CA125 in postmenopausal women. In premenopausal women, HE4 is a promising predictor of Epithelial ovarian cancer; however, its utilisation requires further exploration. Our study elucidates the diagnostic performance of ROMA, HE4 and CA125 in EOC. ROMA is a promising diagnostic marker of Epithelial ovarian cancers in postmenopausal women, while HE4 is the best diagnostic predictor of EOC in the premenopausal group. Our study had only EOC patients as cases and those with benign ovarian masses as controls. Further, we considered the studies estimated using the markers by the same index test: CLIA or ECLIA. The good number of studies with strict inclusion criteria reduced bias because of the pooling of studies with different analytical methods, especially for HE4. We did not consider the studies published in foreign languages. Since a few studies were available for HE4 and CA125 in the premenopausal and postmenopausal group separately, data were inadequate for sub-group analysis. Further, we did not assess these markers' diagnostic efficiency stratified by the stage and type of tumour due to insufficient studies.

show abstract

Section: Resultsmentioning

confidence: 99%

Diagnostic measures comparison for ovarian malignancy risk in Epithelial ovarian cancer patients: a meta-analysis

Suri

Vanamail

Ammalli

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

“…Multiple studies, including meta‐analyses, have highlighted the role of HE4 as a potential complement to CA 125, especially in differentiating benign endometriotic and inflammatory lesions in younger women 25,81–103 . Additional tumor markers (as in the ROMA test) have failed to improve significantly the discrimination between benign and malignant masses compared with CA 125 alone 53,81,84,91,96–109 . The combination of a more extended tumor marker profile, including the addition of carcinoembryonic antigen (CEA) and/or carbohydrate antigen (CA 19‐9) to CA 125, is useful mainly for differentiating between metastatic tumors from the gastrointestinal tract or pancreas and primary ovarian malignancy 110–113 .…”

Section: Resultsmentioning

confidence: 99%

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors

Timmerman

Bourne

Landolfo

et al. 2021

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the preoperative diagnosis of ovarian tumors, including imaging techniques, biomarkers and prediction models.ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the preoperative diagnosis of ovarian tumors and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised.Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The group achieved consensus on 18 statements.This Consensus Statement presents these ESGO/ ISUOG/IOTA/ESGE statements on the preoperative diagnosis of ovarian tumors and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.

show abstract

“…Multiple studies, including meta-analyses, have highlighted the role of HE4 as a potential complement to CA 125, especially in differentiating benign endometriotic and inflammatory lesions in younger women (Al Musalhi et al, 2016;Cao et al, 2018;Huang et al, 2018;Jacob et al, 2011;Jia et al, 2017;Kim et al, 2019;Kotowicz et al, 2015;Li et al, 2012;Lin et al, 2013;Lycke et al, 2018;Melo et al, 2018;Richards et al, 2015;Romagnolo et al, 2016;Sandri et al, 2013;Shin et al, 2020;Stiekema et al, 2014;Terlikowska et al, 2016;Van Gorp et al, 2012;Wang et al, 2014;Xu et al, 2016;Yanaranop et al, 2017;Yanaranop et al, 2018;Yu et al, 2012;Zhang et al, 2015). Additional tumour markers (as in the ROMA test) have failed to improve significantly the discrimination between benign and malignant masses compared with CA 125 alone (Chen et al, 2015;Choi et al, 2020;Cui et al, 2019;Huy et al, 2018;Kaijser, Van Gorp, et al, 2014;Kim et al, 2019;Kotowicz et al, 2015;Lycke et al, 2018;Melo et al, 2018;Piovano et al, 2017;Romagnolo et al, 2016;Sandri et al, 2013;…”

Section: Tumour Markersmentioning

confidence: 99%

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumours

Timmerman¹,

Bourne²,

Landolfo³

et al. 2021

Facts Views Vis ObGyn

View full text Add to dashboard Cite

The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the preoperative diagnosis of ovarian tumours, including imaging techniques, biomarkers and prediction models. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the preoperative diagnosis of ovarian tumours and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when a consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The group achieved consensus on 18 statements. This Consensus Statement presents these ESGO/ISUOG/IOTA/ESGE statements on the preoperative diagnosis of ovarian tumours and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.

show abstract

Discriminative value of CA-125, HE4, Risk of Malignancy Index II (RMI-II) and Risk of Malignancy Algorithm (ROMA) in the differential diagnosis of pelvic masses: conclusions from a referral Centre in Portugal

Cited by 11 publications

References 18 publications

Diagnostic measures comparison for ovarian malignancy risk in Epithelial ovarian cancer patients: a meta-analysis

Diagnostic measures comparison for ovarian malignancy risk in Epithelial ovarian cancer patients: a meta-analysis

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors

ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumours

Contact Info

Product

Resources

About