Preoperative HE4, CA125 and ROMA in the differential diagnosis of benign and malignant adnexal masses

Terlikowska, Katarzyna M.; Dobrzycka, Bożena; Witkowska, Anna; Maćkowiak-Matejczyk, Beata; Sledziewski, Tomasz Kamil; Kinalski, Maciej; Terlikowski, S

doi:10.1186/s13048-016-0254-7

Cited by 40 publications

(33 citation statements)

References 34 publications

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“…Ovarian cancer is the most lethal cancer among gynecological malignancies. It has been estimated that over 151,000 women died from this disease in 2012 worldwide [ 1 ]. In Poland, ovarian cancer is the second most frequently diagnosed malignancy of the female genital tract, with an incidence rate of 3600 new cases per year, and has the highest mortality among gynecological cancers, reaching 2600 deaths every year [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of the gynecology imaging reporting and data system (GI-RADS) with the ovarian malignancy marker CA-125 in preoperative adnexal tumor assessment

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Migda³

et al. 2018

J Ovarian Res

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ObjectivesThe purpose of this study is to assess the preoperative evaluation of an adnexal mass using the GI-RADS classification and to verify whether CA-125 measurement can offer any additional benefits to the GI-RADS-based prediction of ovarian tumor malignancy.Material and methodsIn this study, we assessed a total of 215 women with an adnexal tumor using the GI-RADS classification combined with CA-125 measurement. All adnexal masses underwent histological verification.ResultsOf a total of 215 lesions, we classified 2 lesions as GI-RADS 2 (0.9%), 118 lesions as GI-RADS 3 (54.9%), 86 lesions as GI-RADS 4 (40.0%) and 9 lesions as GI-RADS 5 (4.2%). For GI-RADS 4–5 lesions, the sensitivity, specificity, PPV, NPV, ACC and OR were as follows: 94.3, 72.2, 52.6, 97.5, 77.7%, and 43.3 (CI 12.0–146), respectively. The corresponding parameters resulting from combining the GI-RADS classification with the CA-125 marker were as follows: 66.0, 93.8, 77.8, 89.4, 87.0%, and 29.6 (CI 12.6–69.6), respectively, with p < 0.001. For Ca-125 > 30 IU/mL alone, the results were as follows: 70.0, 80.3, 53.8, 89.1, 77.7%, and 9.5 (4.6–19.6), respectively, with p < 0.0001.Additionally, 47.8% of the patients had no symptoms, 36.5% had back pain, 5.2% had an increased abdominal size, 4.3% had menstrual irregularities and 2.6% had constipation. There were 152 benign and 18 malignant cases in the low risk group (GIRADS 1–3 and GIRADS 4 + CA-125 < 30 IU/mL) and 10 benign and 35 malignant tumors in the high-risk group (GIRADS 4 + CA125 > 30 IU/mL and GIRADS 5).ConclusionsGI-RADS classification had good performance in discriminating ovarian tumors. The additional measurement of CA-125 improves the system specificity, PPV and ACC for preoperative adnexal tumor assessment.

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Section: Introductionmentioning

confidence: 99%

Diagnostic value of the gynecology imaging reporting and data system (GI-RADS) with the ovarian malignancy marker CA-125 in preoperative adnexal tumor assessment

Migda

Migda³

et al. 2018

J Ovarian Res

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“…Nonetheless, they are characterized by low specificity, especially in early stage cancer and in women before menopause [5]. Extensive efforts to identify other OC biomarkers led to the discovery of human epididymis protein 4 (HE4).…”

Section: Introductionmentioning

confidence: 99%

MALDI-TOF-MS analysis in discovery and identification of serum proteomic patterns of ovarian cancer

et al. 2017

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BackgroundDue to high mortality and lack of efficient screening, new tools for ovarian cancer (OC) diagnosis are urgently needed. To broaden the knowledge on the pathological processes that occur during ovarian cancer tumorigenesis, protein-peptide profiling was proposed.MethodsSerum proteomic patterns in samples from OC patients were obtained using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF). Eighty nine serum samples (44 ovarian cancer and 45 healthy controls) were pretreated using solid-phase extraction method. Next, a classification model with the most discriminative factors was identified using chemometric algorithms. Finally, the results were verified by external validation on an independent test set of samples.ResultsMain outcome of this study was an identification of potential OC biomarkers by applying liquid chromatography coupled with tandem mass spectrometry. Application of this novel strategy enabled the identification of four potential OC serum biomarkers (complement C3, kininogen-1, inter-alpha-trypsin inhibitor heavy chain H4, and transthyretin). The role of these proteins was discussed in relation to OC pathomechanism.ConclusionsThe study results may contribute to the development of clinically useful multi-component diagnostic tools in OC. In addition, identifying a novel panel of discriminative proteins could provide a new insight into complex signaling and functional networks associated with this multifactorial disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3467-2) contains supplementary material, which is available to authorized users.

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“…Concentrating on biomarkers, HE4 has been reported to be superior to CA125 in separating benign, borderline ovarian tumors, cancers of the fallopian tubes, as well as early stage epithelial OC [ 29 – 39 ]. Together with CA125 and menopausal status it has been incorporated into the Risk of Ovarian Malignancy Algorithm (ROMA) [ 40 ] and in combination with CA125-II, apolipoprotein A-1, follicle stimulating hormone, and transferrin into the Overa-Test in order to discern malignant from benign pelvic masses [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic markers for the detection of ovarian cancer in BRCA1 mutation carriers

et al. 2017

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BackgroundScreening for ovarian cancer (OC) in women at high risk consists of a combination of carbohydrate antigen 125 (CA125) and transvaginal ultrasound, despite their low sensitivity and specificity. This could be improved by the combination of several biomarkers, which has been shown in average risk patients but has not been investigated until now in female BRCA mutation carriers.MethodsUsing a multiplex, bead-based, immunoassay system, we analyzed the concentrations of leptin, prolactin, osteopontin, insulin-like growth factor II, macrophage inhibitory factor, CA125 and human epididymis antigen 4 in 26 healthy wild type women, 26 healthy BRCA1 mutation carriers, 28 wildtype OC patients and 26 OC patients with BRCA1 mutation.ResultsUsing the ROC analysis, we found a high overall sensitivity of 94.3% in differentiating healthy controls from OC patients with comparable results in the wildtype subgroup (sensitivity 92.8%, AUC = 0.988; p = 5.2e-14) as well as in BRCA1 mutation carriers (sensitivity 95.2%, AUC = 0.978; p = 1.7e-15) at an overall specificity of 92.3%.The used algorithm also allowed to identify healthy BRCA1 mutation carriers when compared to healthy wildtype women (sensitivity 88.4%, specificity 80.7%, AUC = 0.895; p = 6e-08), while this was less pronounced in patients with OC (sensitivity 66.7%, specificity 67.8%, AUC = 0.724; p = 0.00065).ConclusionWe have developed an algorithm, which can differentiate between healthy women and OC patients and have for the first time shown, that such an algorithm can also be used in BRCA mutation carriers. To clarify a suggested benefit to the existing early detection program, large prospective trials with mainly early stage OC cases are warranted.

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Preoperative HE4, CA125 and ROMA in the differential diagnosis of benign and malignant adnexal masses

Cited by 40 publications

References 34 publications

Diagnostic value of the gynecology imaging reporting and data system (GI-RADS) with the ovarian malignancy marker CA-125 in preoperative adnexal tumor assessment

Diagnostic value of the gynecology imaging reporting and data system (GI-RADS) with the ovarian malignancy marker CA-125 in preoperative adnexal tumor assessment

MALDI-TOF-MS analysis in discovery and identification of serum proteomic patterns of ovarian cancer

Diagnostic markers for the detection of ovarian cancer in BRCA1 mutation carriers

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