Online ISSN: 2515-8260

Keywords : HE4


Original Research Article: Clinical Study On Diagnostic Accuracy Of ROMA (Risk Of Malignancy Algorhithm) Score In Predicting Epithelial Ovarian Cancers For Ovarian Mass

Dr Nirav Jetani, Dr Steffi D Gandhi, Dr Ujjval Parikh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 938-951

Background: Ovarian malignant tumors have varied clinical and biologic behaviour. It is the sixth most common cancer among women (Age standaradised incidence rate being 6.6/100,000) and seventh leading cause of cancer deaths globally (age standaradised mortality rate being 4.0/100,00)In India, during the period 2004-2005, proportion of ovarian cancer varied from 1.7% to 8.7% of all female cancers in various population based registries of Indian Council of Medical Research. The proportion of this cancer was 6.0%-7.7% of all cancers among females in Gujarat.
Objectives: To Determine Diagnostic accuracy of ROMA Score using HE4 and CA 125 for Epithelial Ovarian Cancer. 
Methodology: This prospective study using a sample of 50 patients who attends the gynecology out Patient department and  Labour room between September 2018 and July 2019 for the evaluation of an ovarian mass. Blood specimens from these patients was obtained during their first assessment for laboratory work up. From the variables collection ROMA was calculated using CA-125 and HE4 results. Boththe receiver operating characteristic (ROC) curve and area under the curve (AUC) was calculated(accordingly), and the most valid cut-offs was determined accordingly. For all statistical comparisons, a p-value < 0.050 was accepted as statistically significant.
Result: Thirty-three subjects (66%) had Benign and Seventeen subjects(34%) had Malignant disease.For diagnostic modalities observation of my study is   Maximum number of benign cases found by histopathological(66%) and serum CA-125(66%). Maximum number of malignant cases found by USG(48%) and CECT/MRI(48%). Maximum number (54%) of cases were found in 18- 44 age- group.For CA-125, mean and median values were 70.35 and 75 respectively for cases with benign disease and 373.4 and 346.8 respectively for cases with malignant disease. This association was statistically significant (p<0.05).For HE-4, mean and median values were 42.28 and 38 respectively for cases with benign disease and 301.17 and 240 respectively for cases with malignant disease. This association was statistically significant (p<0.05).For ROMA score, mean and median values were 4% and 3% respectively for cases with benign disease and 56.33% and 50.65% respectively for cases with malignant disease. This association was statistically significant (p<0.05).
Conclusion:. HE4 and ROMA showed a high specificity, but were less sensitivity than CA-125 and RMI in premenopausal women. However, ROMA is of comparable sensitivity and HE4 has highest specificity as compared to CA125 in postmenopausal women