{"title":"CA-125、RMI、HE4和ROMA对无功能卵巢囊肿女性癌症预测的诊断价值评估","authors":"Shina Oranratanaphan, Sinee Wanishpongpan, Wichai Termrungruanglert, Surang Triratanachat","doi":"10.1155/2018/7821574","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic performance among CA-125, RMI, HE4, and ROMA for cancer detection in women with nonfunctional ovarian cysts at King Chulalongkorn Memorial Hospital (KCMH). Secondary objective is to reconsider the proper cutoff value of HE4.</p><p><strong>Methods: </strong>This is a prospective analytic study in women with nonfunctional ovarian cysts larger than 3 cm who scheduled for surgery at KCMH during 3<sup>rd</sup> June 2015 to 31<sup>st</sup> May 2016. Ultrasonogram and blood sample collection were completed before the operation. Patients' demographic information and pathologic results were obtained. SPSS software version 17 was used for statistical evaluation.</p><p><strong>Results: </strong>A total of 281 participants were evaluated. 19.9% of them were malignant. Compared with CA-125, HE4 had lower sensitivity (53.4% vs. 87.9%) and NPV (89% vs. 93.6%) but higher specificity (97.8% vs. 46.2%) and PPV (86.1% vs. 29.8%). ROMA had slightly lower sensitivity (79.3% vs. 87.9%) and similar NPV (93.7% vs. 93.6%), but higher specificity (79.8% vs. 46.2%) and PPV (50.5% vs. 29.8%) compared with CA-125. The model that achieves the highest area under the ROC curve in differentiating benign versus malignant ovarian tumor was ROMA. Cutoff value of HE4 at 70 pMol/L (from 150 pMol/L) would give sensitivity 74.1% and specificity 86.5% that are comparable with ROMA.</p><p><strong>Conclusions: </strong>HE4 and ROMA had better performance (higher specificity, PPV) compared to CA-125 and RMI. HE4 at 70 pMol/L could be the new cutoff value for Thai women with ovarian cysts, giving higher sensitivity and specificity.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2018 ","pages":"7821574"},"PeriodicalIF":1.6000,"publicationDate":"2018-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/7821574","citationCount":"9","resultStr":"{\"title\":\"Assessment of Diagnostic Values among CA-125, RMI, HE4, and ROMA for Cancer Prediction in Women with Nonfunctional Ovarian Cysts.\",\"authors\":\"Shina Oranratanaphan, Sinee Wanishpongpan, Wichai Termrungruanglert, Surang Triratanachat\",\"doi\":\"10.1155/2018/7821574\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate the diagnostic performance among CA-125, RMI, HE4, and ROMA for cancer detection in women with nonfunctional ovarian cysts at King Chulalongkorn Memorial Hospital (KCMH). Secondary objective is to reconsider the proper cutoff value of HE4.</p><p><strong>Methods: </strong>This is a prospective analytic study in women with nonfunctional ovarian cysts larger than 3 cm who scheduled for surgery at KCMH during 3<sup>rd</sup> June 2015 to 31<sup>st</sup> May 2016. Ultrasonogram and blood sample collection were completed before the operation. Patients' demographic information and pathologic results were obtained. SPSS software version 17 was used for statistical evaluation.</p><p><strong>Results: </strong>A total of 281 participants were evaluated. 19.9% of them were malignant. Compared with CA-125, HE4 had lower sensitivity (53.4% vs. 87.9%) and NPV (89% vs. 93.6%) but higher specificity (97.8% vs. 46.2%) and PPV (86.1% vs. 29.8%). ROMA had slightly lower sensitivity (79.3% vs. 87.9%) and similar NPV (93.7% vs. 93.6%), but higher specificity (79.8% vs. 46.2%) and PPV (50.5% vs. 29.8%) compared with CA-125. The model that achieves the highest area under the ROC curve in differentiating benign versus malignant ovarian tumor was ROMA. Cutoff value of HE4 at 70 pMol/L (from 150 pMol/L) would give sensitivity 74.1% and specificity 86.5% that are comparable with ROMA.</p><p><strong>Conclusions: </strong>HE4 and ROMA had better performance (higher specificity, PPV) compared to CA-125 and RMI. HE4 at 70 pMol/L could be the new cutoff value for Thai women with ovarian cysts, giving higher sensitivity and specificity.</p>\",\"PeriodicalId\":19439,\"journal\":{\"name\":\"Obstetrics and Gynecology International\",\"volume\":\"2018 \",\"pages\":\"7821574\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2018-10-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1155/2018/7821574\",\"citationCount\":\"9\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Obstetrics and Gynecology International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2018/7821574\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2018/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obstetrics and Gynecology International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2018/7821574","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 9
摘要
目的:评价CA-125、RMI、HE4和ROMA在朱拉隆功国王纪念医院(KCMH)非功能性卵巢囊肿女性癌症诊断中的表现。次要目标是重新考虑适当的HE4截止值。方法:这是一项前瞻性分析研究，研究对象为2015年6月3日至2016年5月31日在KCMH计划手术的大于3cm的非功能性卵巢囊肿女性。术前完成超声检查及血液采集。获得患者的人口学信息和病理结果。采用SPSS 17版软件进行统计评价。结果:共有281名参与者被评估。恶性肿瘤占19.9%。与CA-125相比，HE4的敏感性(53.4%比87.9%)和NPV(89%比93.6%)较低，但特异性(97.8%比46.2%)和PPV(86.1%比29.8%)较高。与CA-125相比，ROMA的敏感性略低(79.3% vs. 87.9%)， NPV相似(93.7% vs. 93.6%)，但特异性(79.8% vs. 46.2%)和PPV (50.5% vs. 29.8%)更高。在区分卵巢良恶性肿瘤时，ROC曲线下面积最大的模型是ROMA。HE4的临界值为70 pMol/L(从150 pMol/L)，灵敏度为74.1%，特异性为86.5%，与ROMA相当。结论:与CA-125和RMI相比，HE4和ROMA具有更好的性能(更高的特异性，PPV)。70 pMol/L的HE4可作为泰国女性卵巢囊肿的新临界值，具有更高的敏感性和特异性。
Assessment of Diagnostic Values among CA-125, RMI, HE4, and ROMA for Cancer Prediction in Women with Nonfunctional Ovarian Cysts.
Objectives: To evaluate the diagnostic performance among CA-125, RMI, HE4, and ROMA for cancer detection in women with nonfunctional ovarian cysts at King Chulalongkorn Memorial Hospital (KCMH). Secondary objective is to reconsider the proper cutoff value of HE4.
Methods: This is a prospective analytic study in women with nonfunctional ovarian cysts larger than 3 cm who scheduled for surgery at KCMH during 3rd June 2015 to 31st May 2016. Ultrasonogram and blood sample collection were completed before the operation. Patients' demographic information and pathologic results were obtained. SPSS software version 17 was used for statistical evaluation.
Results: A total of 281 participants were evaluated. 19.9% of them were malignant. Compared with CA-125, HE4 had lower sensitivity (53.4% vs. 87.9%) and NPV (89% vs. 93.6%) but higher specificity (97.8% vs. 46.2%) and PPV (86.1% vs. 29.8%). ROMA had slightly lower sensitivity (79.3% vs. 87.9%) and similar NPV (93.7% vs. 93.6%), but higher specificity (79.8% vs. 46.2%) and PPV (50.5% vs. 29.8%) compared with CA-125. The model that achieves the highest area under the ROC curve in differentiating benign versus malignant ovarian tumor was ROMA. Cutoff value of HE4 at 70 pMol/L (from 150 pMol/L) would give sensitivity 74.1% and specificity 86.5% that are comparable with ROMA.
Conclusions: HE4 and ROMA had better performance (higher specificity, PPV) compared to CA-125 and RMI. HE4 at 70 pMol/L could be the new cutoff value for Thai women with ovarian cysts, giving higher sensitivity and specificity.
期刊介绍：
Obstetrics and Gynecology International is a peer-reviewed, Open Access journal that aims to provide a forum for scientists and clinical professionals working in obstetrics and gynecology. The journal publishes original research articles, review articles, and clinical studies related to obstetrics, maternal-fetal medicine, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine and infertility, reproductive endocrinology, and sexual medicine.
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