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Title: The use of HE4 in the prediction of ovarian cancer in Asian women with a pelvic mass
Authors: Karen K.L. Chan
Chi An Chen
Joo Hyun Nam
Kazunori Ochiai
Sarikapan Wilailak
Aw Tar Choon
Subathra Sabaratnam
Sudarshan Hebbar
Jaganathan Sickan
Beth A. Schodin
Walfrido W. Sumpaico
The University of Hong Kong
National Taiwan University Hospital
University of Ulsan, College of Medicine
Jikei University
Mahidol University
Changi General Hospital
Hospital Sultanah Aminah
Abbott Laboratories
Manila Central University
Reata Pharmaceuticals, Inc.
Keywords: Medicine
Issue Date: 1-Feb-2013
Citation: Gynecologic Oncology. Vol.128, No.2 (2013), 239-244
Abstract: Objective: The purpose of this study was to evaluate the performance of human epididymis protein 4 (HE4) and the Risk of Ovarian Malignancy Algorithm (ROMA) for distinguishing between benign and malignant pelvis masses in Asian women. Methods: This was a prospective, multicenter (n = 6) study with patients from six Asian countries. Patients had a pelvic mass on imaging and were scheduled to undergo surgery. Serum CA125 and HE4 were measured on preoperative samples. CA125, HE4, and ROMA were evaluated for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: A total of 414 women with an adnexal mass were evaluated, of which 65 had epithelial ovarian (EOC) cancer, 16 had borderline tumors and 11 had other malignant diseases. Compared to CA125, HE4 had lower sensitivity (56.9% vs 90.8%) and NPV (91.8% vs 97.3%), but improved specificity (96.9% vs 67.1%) and PPV (78.7% vs 35.8%) for differentiating between benign pelvic mass and EOC. ROMA had similar sensitivity (89.2% vs 90.8%) and NPV (97.6% vs 97.3%) as CA125, but showed improved specificity (87.3% vs 67.1%) and PPV (58.6% vs 35.8%). ROMA accurately predicted 87.3% of benign cases as low risk, and 82.6% of stage I/II EOC and 89.2% of all EOC as high risk. Conclusion: ROMA showed similar sensitivity as CA125 but improved specificity and PPV, especially in premenopausal women. Using ROMA may help predict if a pelvic mass is benign or malignant and facilitate subsequent management planning. © 2012 Elsevier Inc. All rights reserved.
ISSN: 10956859
Appears in Collections:Scopus 2011-2015

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