A Comparative Study of RMI and ROMA in Women Presenting with an Adnexal Mass

Priyanka, Vemanamandhi; Karthiga, Sivaprakasam; Sivanesan, B.; Jagadeesan, Nithya; Balasubramani, Latha

doi:10.1007/s40944-017-0168-3

Cited by 4 publications

(10 citation statements)

References 18 publications

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“…For example, 55 studies selected participants based on disease status, 31 studies included patients below 18 years, and 19 others were excluded because it was not possible to assess eligibility due to incomplete reporting (Table S1). A final set of 17 studies was included in this review, [14][15][16][26][27][28][29][30][31][32][33][34][35][36][37][38][39] of which a total of 13 studies could be included in meta-analyses; seven studies in the main analysis of HE4, 26,30,34,[36][37][38][39] eight studies in the main analysis of CA125, 26,27,[29][30][31][32]34,37 four studies in the comparative analysis, 26,30,34,37 four in the HE4 subgroup analysis 28,29,32,33 and six in the CA125 subgroup analysis 26,28,29,32,33,35 (Figure…”

Section: Search Resultsmentioning

confidence: 99%

“…For example, one study only reported that it "(…) was carried out in the outpatient department of GKNM Hospital on women presenting with an adnexal mass clinically and radiologically". 28 Exclusion criteria were clearly reported in 14 of the 17 studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eight studies reported a subgroup analysis, distinguishing between pre-and postmenopausal women. Of these, four used the same cut-off values of 70 pmol/L for pre-menopausal women and 140 pmol/L for post-menopausal women and were therefore included in a subgroup meta-analysis 28,29,32,33 (Table S11).…”

Section: Evaluation Of He4mentioning

confidence: 99%

“…Since none of the included studies for the meta-analysis of HE4 classified BOT as malignant, we excluded four studies that classified BOT as malignant from the analysis of CA125, for consistency. Thus eight studies were included in a meta-analysis of CA125 26,[28][29][30][31][32]34,37 (Table S12).…”

Section: Evaluation Of Ca125mentioning

confidence: 99%

“…Six studies evaluated CA125 for pre-and postmenopausal women separately using the same cut-off value of 35 U/mL and we therefore included these studies in the subgroup meta-analysis for CA125 26,28,29,32,33,35 (Table S12).…”

Section: Evaluation Of Ca125mentioning

confidence: 99%

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The diagnostic accuracy of human epididymis protein 4 (HE4) for discriminating between benign and malignant pelvic masses: a systematic review and meta‐analysis

Olsen

Lof

Stiekema

et al. 2021

Acta Obstet Gynecol Scand

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Introduction: Many women with benign pelvic masses, suspected of ovarian cancer, are unnecessarily referred for treatment at specialized centers. There is an unmet clinical need to improve diagnostic assessment in these patients. Our objective was to obtain summary estimates of the accuracy of human epididymis protein (HE4) for diagnosing ovarian cancer and to compare the performance of HE4 with that of cancer antigen 125 (CA125). Material and methods:We searched PubMed, Ovid and Scopus using search terms for "pelvic masses" and "HE4", to identify studies that evaluated HE4 for diagnosing malignant ovarian masses, in adult women presenting with a pelvic mass, suspected of ovarian cancer, and with diagnosis confirmed by histopathology. Screening, data extraction and Risk of Bias assessment with the QUADAS-2 tool were done independently by two authors. We performed a meta-analysis of the accuracy of HE4 and CA125 using a random-effects bivariate logit-normal model. A study protocol was registered at PROSPERO (CRD42020158073).Results: In the 17 eligible studies, which included 3404 patients, ovarian cancer prevalence ranged from 15% to 71%. Overall, the studies were heterogeneous. All studies seemed to have recruited patients in specialized settings. A meta-analysis of seven HE4 studies resulted in a mean sensitivity of 79.4% (95% confidence interval [CI] 74.1%-83.8%) and a mean specificity of 84.1% (95% CI 79.6%-87.8%), for cut-off values of 67-72 pmol/L. Based on eight studies, the mean sensitivity of CA125 was 81.4% (95% CI 74.6%-86.2%) and the mean specificity was 56.8% (95% CI 47.9%-65.4%), at a cut-off of 35 U/ml. Given a 40% ovarian cancer prevalence, the positive predictive value (PPV) for HE4 would be 76.9% (71.9%-81.2%) vs 55.6% (50.2%-60.9%) for CA125. The negative predictive value (NPV) would be 85.9 (82.8%-88.6%) and 81.9% (76.2%-86.4%), respectively. At a 15% prevalence, the NPV would be 95.8%The search string consisted of a variety of search terms for "pelvic cysts or tumors" and "human epididymis protein 4" (Appendix S1).The search was performed in MEDLINE (PubMed), Embase (Ovid) (95% CI 94.4%-96.7%) for HE4 and 94.4% (95% CI 92.3%-96.0%) for CA125. The PPV would be 46.9% (40.4%-53.4%) and 24.9% (21.1%-29.2%), respectively.Conclusions: HE4 had higher specificity and similar sensitivity compared with CA125.At high prevalence, PPV was also higher for HE4, but at low prevalence, it had a similar NPV to CA125. The field would benefit from studies conducted in general settings.

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Section: Search Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Evaluation Of He4mentioning

confidence: 99%

Section: Evaluation Of Ca125mentioning

confidence: 99%

Section: Evaluation Of Ca125mentioning

confidence: 99%

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The diagnostic accuracy of human epididymis protein 4 (HE4) for discriminating between benign and malignant pelvic masses: a systematic review and meta‐analysis

Olsen

Lof

Stiekema

et al. 2021

Acta Obstet Gynecol Scand

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Comparing the Diagnostic Value of the Risk of Ovarian Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI) in Women with an Adnexal Mass

Honarvar

Monshi

Robati

2021

Indian J Gynecol Oncolog

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Biomarkers for Early Diagnosis of Ovarian Carcinoma

Manasa¹,

Mascarenhas²,

Shetti

et al. 2022

ACS Biomater. Sci. Eng.

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The leading cause of gynecological cancer-related morbidity and mortality is ovarian cancer (OC), which is dubbed a silent killer. Currently, OC is a target of intense biomarker research, because it is often not discovered until the disease is advanced. The goal of OC research is to develop effective tests using biomarkers that can detect the disease at the earliest stages, which would eventually decrease the mortality, thereby preventing recurrence. Therefore, there is a pressing need to revisit the existing biomarkers to recognize the potential biomarkers that can lead to efficient predictors for the OC diagnosis. This Perspective covers an update on the currently available biomarkers used in the triaging of OC to gain certain insights into the potential role of these biomarkers and their estimation that are crucial to the understanding of neoplasm progression, diagnostics, and therapy.

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A Comparative Study of RMI and ROMA in Women Presenting with an Adnexal Mass

Cited by 4 publications

References 18 publications

The diagnostic accuracy of human epididymis protein 4 (HE4) for discriminating between benign and malignant pelvic masses: a systematic review and meta‐analysis

The diagnostic accuracy of human epididymis protein 4 (HE4) for discriminating between benign and malignant pelvic masses: a systematic review and meta‐analysis

Comparing the Diagnostic Value of the Risk of Ovarian Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI) in Women with an Adnexal Mass

Biomarkers for Early Diagnosis of Ovarian Carcinoma

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