Publication: The use of HE4 in the prediction of ovarian cancer in Asian women with a pelvic mass
Issued Date
2013-02-01
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ISSN
10956859
00908258
00908258
Other identifier(s)
2-s2.0-84872856746
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Mahidol University
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SCOPUS
Bibliographic Citation
Gynecologic Oncology. Vol.128, No.2 (2013), 239-244
Suggested Citation
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 use of HE4 in the prediction of ovarian cancer in Asian women with a pelvic mass. Gynecologic Oncology. Vol.128, No.2 (2013), 239-244. doi:10.1016/j.ygyno.2012.09.034 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/32567
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Title
The use of HE4 in the prediction of ovarian cancer in Asian women with a pelvic mass
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.