Role of HE4 in evaluation of adnexal masses and its comparison with CA125, ROMA and RMI in premenopausal women.

IF 0.9 African health sciences Pub Date : 2024-12-01 DOI:10.4314/ahs.v24i4.16
Mini Sharma, Neeraj Kumar, Subhas Saha, Vanita Suri, G R Prasad, Radhika Srinivasan, Arnab Pal
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Abstract

Background: Ovarian cancer is the seventh most common cancer in women and is ranked third among gynaecological malignancies after cervical and uterine cancers. Prospective studies have failed to establish a definite screening programme based on tumour markers or ultrasonography.

Objective: To evaluate potential role of Human Epididymis protein 4 (HE4) as a biomarker for diagnosis of various ovarian malignancies in premenopausal age group, either alone or as a part of diagnostic algorithm like Risk of Malignancy Algorithm (ROMA) and to analyse if it has any advantage over Cancer Antigen 125 (CA125) or Risk of Malignancy Index (RMI).

Methods: It was an observational cross-sectional study which included 100 premenopausal women having ovarian mass and underwent surgery. The diagnostic performances of CA125, HE4, ROMA score and RMI for ovarian cancer were evaluated.

Results: Postoperative histopathology confirmed 30% (n=30) women to have malignant ovarian tumors. According to receiver operating characteristic (ROC) analysis; area under curve (AUC) was maximum for ROMA (0.791) followed by HE4 (0.784), RMI (0.750) and CA125 (0.715).

Conclusion: HE4 is not superior to CA125 but, it can be used in series or as part of diagnostic algorithm (ROMA) along with CA125 to get higher diagnostic accuracy for premenopausal women.

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HE4 在绝经前妇女附件肿块评估中的作用及其与 CA125、ROMA 和 RMI 的比较。
背景:卵巢癌是女性第七大常见癌症,在妇科恶性肿瘤中排名第三,仅次于子宫颈癌和子宫癌。前瞻性研究未能建立基于肿瘤标志物或超声检查的明确筛查方案。目的:评估人类附睾蛋白4 (HE4)作为绝经前年龄群体各种卵巢恶性肿瘤诊断的生物标志物的潜在作用,无论是单独使用还是作为恶性肿瘤风险算法(ROMA)等诊断算法的一部分,并分析其是否比癌症抗原125 (CA125)或恶性肿瘤风险指数(RMI)有任何优势。方法:采用观察性横断面研究,纳入100例绝经前卵巢肿块并行手术治疗的妇女。评价CA125、HE4、ROMA评分及RMI对卵巢癌的诊断价值。结果:术后组织病理学证实30% (n=30)女性卵巢恶性肿瘤。根据受试者工作特征(ROC)分析;曲线下面积(AUC)最大的是ROMA(0.791),其次是HE4(0.784)、RMI(0.750)和CA125(0.715)。结论:HE4并不优于CA125,但可与CA125串联或作为诊断算法(ROMA)的一部分使用,可提高绝经前妇女的诊断准确性。
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