Comparison of Human Epididymis Protein 4, Cancer Antigen 125, and Ultrasound Prediction Model in Differentiating Benign from Malignant Adnexal Masses.

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Journal of Mid-life Health Pub Date : 2023-07-01 Epub Date: 2023-12-30 DOI:10.4103/jmh.jmh_77_23

Anupama Bahadur, Namrata Bhattacharya, Rajlaxmi Mundhra, Kavita Khoiwal, Latika Chawla, Rajni Singh, Manisha Naithani, Sanjeev Kishore

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引用次数: 0

Abstract

Background: This study aimed to compare the diagnostic performance of carcinogenic antigen (CA) 125, (HE)-4 (Human epididymis protein 4), and ultrasound (International Ovarian Tumor Analysis [IOTA]) Simple Rules individually and to derive a composite score in the differentiating ovarian cancer from benign ovarian mass.

Subjects and methods: Consecutive patients (n = 100) with pelvic mass admitted during February 2018-August 2019 were included prospectively. Patients with either known case of epithelial ovarian cancer (EOC) or metastatic EOC were excluded. The primary outcome was to assess the sensitivity and specificity of CA-125, HE-4, and IOTA Simple Rules in predicting benign from malignant mass independently, while secondary outcome was derivation of a new model incorporating these variables using multivariate logistic regression analysis to predict benign from malignant lesions. Receiver operator curve (ROC) was drawn to redefine the best-performing cutoff values and difference between area under the ROC (AUROC) were compared by DeLong's method.

Results: Out of 100 cases of adnexal mass selected, the sensitivity and specificity of CA-125 were 73.8% and 77.6%, HE-4 were 90.5% and 87.9%, and IOTA Simple Rules were 92.9% and 81.0%. CA-125, HE-4, and IOTA Simple Rules were independently associated with the likelihood of malignancy/borderline (P < 0.001). The area under the curve for the "composite score" (AUC = 0.93) was the highest and was significantly better than that of CA-125 (AUC = 0.786) (P = 0.004 using DeLong's test) and comparable with HE-4 (AUROC = 0.90; P = 0.128 using DeLong's Test).

Conclusion: The sensitivity and specificity of HE-4 and IOTA Simple Rules for predicting malignant ovarian tumor was better than those of CA-125. The diagnostic performance of "composite score" was comparable to those of either HE-4 or IOTA Simple Rules and significantly better than CA-125.

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比较人类附睾蛋白 4、癌抗原 125 和超声波预测模型在区分良性和恶性附件肿块中的作用

背景：本研究旨在比较致癌抗原（CA）125、（HE）-4（人附睾蛋白4）和超声（国际卵巢肿瘤分析[IOTA]）简单规则单独使用的诊断性能，并得出区分卵巢癌和良性卵巢肿块的综合评分：前瞻性纳入2018年2月至2019年8月期间收治的盆腔肿块连续患者（n = 100）。排除已知患有上皮性卵巢癌（EOC）或转移性EOC的患者。主要结果是评估CA-125、HE-4和IOTA简单规则独立预测良性和恶性肿块的敏感性和特异性，次要结果是使用多变量逻辑回归分析推导出包含这些变量的新模型，以预测良性和恶性病变。通过绘制受体运算曲线（ROC）来重新定义表现最佳的截断值，并用 DeLong 方法比较 ROC 下面积（AUROC）之间的差异：在选取的 100 例附件肿块中，CA-125 的敏感性和特异性分别为 73.8%和 77.6%，HE-4 的敏感性和特异性分别为 90.5%和 87.9%，IOTA 简易规则的敏感性和特异性分别为 92.9%和 81.0%。CA-125、HE-4 和 IOTA 简易规则与恶性/边缘可能性独立相关（P < 0.001）。综合评分 "的曲线下面积（AUC = 0.93）最高，明显优于 CA-125（AUC = 0.786）（使用 DeLong 检验，P = 0.004），与 HE-4 相当（AUROC = 0.90；使用 DeLong 检验，P = 0.128）：结论：HE-4和IOTA简单规则预测恶性卵巢肿瘤的敏感性和特异性均优于CA-125。综合评分 "的诊断性能与 HE-4 或 IOTA 简易规则相当，明显优于 CA-125。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Mid-life Health Social Sciences-Health (social science)

CiteScore

1.70

自引率

9.10%

发文量

审稿时长

43 weeks

期刊介绍： Journal of mid-life health is the official journal of the Indian Menopause society published Quarterly in January, April, July and October. It is peer reviewed, scientific journal of mid-life health and its problems. It includes all aspects of mid-life health, preventive as well as curative. The journal publishes on subjects such as gynecology, neurology, geriatrics, psychiatry, endocrinology, urology, andrology, psychology, healthy ageing, cardiovascular health, bone health, quality of life etc. as relevant of men and women in their midlife. The Journal provides a visible platform to the researchers as well as clinicians to publish their experiences in this area thereby helping in the promotion of mid-life health leading to healthy ageing, growing need due to increasing life expectancy. The Editorial team has maintained high standards and published original research papers, case reports and review articles from the best of the best contributors both national & international, consistently so that now, it has become a great tool in the hands of menopause practitioners.