The ROMA (Risk of Ovarian Malignancy Algorithm) for estimating the risk of epithelial ovarian cancer in women presenting with pelvic mass: is it really useful?
-
Martina Montagnana
,
Elisa Danese
Abstract
Background: The study is aimed at evaluating the performance of the predictive model ROMA (Risk of Ovarian Malignancy Algorithm), which utilizes the combination of human epididymis protein 4 (HE4) and CA125 values to assess the risk of epithelial ovarian cancer (EOC) in women with a pelvic mass.
Methods: One hundred and four women diagnosed with a pelvic mass (55 EOC and 49 benign cases) and scheduled to have surgery were enrolled, along with 49 healthy females. Preoperative serum concentrations of HE4 and CA125 were measured. Separate logistic regression algorithms ROMA for pre-menopausal and post-menopausal women were used to categorize patients into low- and high-risk groups for EOC. The area under the curve (AUC), sensitivity and specificity were calculated for HE4, CA125 and ROMA for the diagnosis of ovarian cancer using receiver operating characteristic (ROC) analysis.
Results: The median CA125 and HE4 serum concentrations were significantly higher among EOC patients than in healthy females (both p<0.05) and those with a benign mass (both p<0.05). The pre-menopausal group included 36 benign cases (29 of which were classified by ROMA as low-risk with a specificity of 80.6%; 95% CI: 64.0%–91.8%), and 15 EOC (eight of which were classified by ROMA as high-risk, with a sensitivity of 53.3%; 95% CI: 26.6%–78.7%). The post-menopausal group enclosed 13 benign cases (11 of which were classified by ROMA as low-risk with a specificity of 84.6%; 95% CI: 54.6%–98.0%), and 40 EOC (33 of which were classified by ROMA as high-risk with a sensitivity of 82.5%; 95% CI: 67.2%–92.7%). In the pre-menopausal group, the AUC was 0.64 (p=0.12, 95% CI: 0.44–0.83) for CA125, 0.77 (p=0.003, 95% CI: 0.62–0.92) for HE4 and 0.77 (p=0.002, 95% CI: 0.63–0.92) for ROMA. In the post-menopausal group, the AUC was 0.84 (p=0.0003, 95% CI: 0.73–0.94) for CA125, 0.94 (p<0.0001, 95% CI: 0.88–0.99) for HE4 and 0.92 (p<0.0001, 95% CI: 0.85–0.99) for ROMA.
Conclusions: The ROMA is a simple scoring system which shows excellent diagnostic performance for the detection of EOC in post-menopausal women, but not in pre-menopausal women. Moreover, the dual marker combination of HE4 and CA125 (ROMA) does not show better performance than HE4 alone.
©2011 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Editorial
- Biomarkers of neurodegenerative diseases
- Reviews
- CSF biomarkers in neurodegenerative diseases
- Tau and p-tau as CSF biomarkers in dementia: a meta-analysis
- Amyloid β (Aβ) and phospho-tau (p-tau) as diagnostic biomarkers in Alzheimer's disease
- The effect of apolipoprotein E (ApoE) genotype on biomarkers of amyloidogenesis, tau pathology and neurodegeneration in Alzheimer's disease
- Advanced glycation endproducts as gerontotoxins and biomarkers for carbonyl-based degenerative processes in Alzheimer's disease
- Parkinson's disease – the continuing search for biomarkers
- α-Synuclein in Parkinson disease and other neurodegenerative disorders
- S100B protein in neurodegenerative disorders
- Inflammatory and structural biomarkers in acute traumatic spinal cord injury
- Homocysteine: a biomarker in neurodegenerative diseases
- Editorial
- ROMA or death: advances in epithelial ovarian cancer diagnosis
- Review
- Laboratory testing for the antiphospholipid syndrome: making sense of antiphospholipid antibody assays
- General Clinical Chemistry and Laboratory Medicine
- Quality indicators and specifications for key analytical-extranalytical processes in the clinical laboratory. Five years’ experience using the Six Sigma concept
- Determination of oxidative and occupational stress in palliative care workers
- Effect of cigarette smoking on plasma homocysteine concentrations
- Erythrocyte membrane protein analysis by sodium dodecyl sulphate-capillary gel electrophoresis in the diagnosis of hereditary spherocytosis
- Evaluation of hematological parameters on admission for the prediction of 7-day in-hospital mortality in a large trauma cohort
- Platelet function testing in hirudin and BAPA anticoagulated blood
- Evaluation of the iChem® Velocity™ Urine Chemistry Analyzer in a hospital routine laboratory
- Crystalluria: prevalence, different types of crystals and the role of infrared spectroscopy
- Cancer Diagnostics
- The ROMA (Risk of Ovarian Malignancy Algorithm) for estimating the risk of epithelial ovarian cancer in women presenting with pelvic mass: is it really useful?
- Evaluation of the accuracy of serum human epididymis protein 4 in combination with CA125 for detecting ovarian cancer: a prospective case-control study in a Korean population
- Cardiovascular Diseases
- APOA5 −1131T/C polymorphism is associated with coronary artery disease in a Chinese population: a meta-analysis
- Assessment of the nickel-albumin binding assay for diagnosis of acute coronary syndrome
- Letters to the Editor
- AGER gene -374T>A (rs1800624) polymorphism is not associated with the severity of non-diabetic coronary artery disease in Han Chinese
- Some lessons learned from using medium scale genotyping techniques in pharmacogenetic research
- Improved neopterin ELISA kit: a good compromise between HPLC results and clinical practice
- Cross-reactivity of 25-hydroxy vitamin D2 from different commercial immunoassays for 25-hydroxy vitamin D: an evaluation without spiked samples
- Modulated human maternal and premature neonatal erythrocyte membrane enzyme activities in relation to the mode of delivery: in vitro restoration with L-Carnitine
