Volume 79, Issue 3 (june 2021)                   Tehran Univ Med J 2021, 79(3): 193-200 | Back to browse issues page

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Tehranian A, Ghahghaei-Nezamabadi A, Yarmohammadi N, Ganjeh M, Maajaani K, Aghajani R. Evaluation of diagnostic accuracy of RMI and ROMA indices in comparison to HE4 and CA125 parameters for estimating the risk of malignancy of adnexal masses.. Tehran Univ Med J 2021; 79 (3) :193-200
URL: http://tumj.tums.ac.ir/article-1-11229-en.html
1- Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.
2- Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Epidemiology, School of public Health, Tehran University of Medical Sciences, Tehran, Iran.
4- Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Abstract:   (782 Views)
Background: Ovarian cancer is the fifth leading cancer-related cause of death in women worldwide and is often diagnosed at advanced stages. Regarding the low sensitivity and specificity of the currently available diagnostic techniques, in the present study, we aimed to evaluate the accuracy of RMI and ROMA indexes and comparing these two indexes with CA-125 and HE4 parameters for the diagnosis and differentiation between benign and malignant ovarian tumors. Also, we determined the optimal cut-off level of these markers in patients who attended Arash Women’s Hospital.
Methods: In this cross-sectional study, we included 137 women with ovarian mass who were attended the gynecology clinic of Arash Women's Hospital, Tehran, Iran (April 2017-April 2019), and were eligible according to the inclusion criteria. We included patients with an adnexal mass over 3 cm. Our exclusion criteria were as the following: pregnancy, age under 18 and over 90 years, taking hormonal agents, renal failure, suspected ovarian torsion, ovarian cancer and taking antibiotics, nitric oxide compounds, and heavy metals. Based on serum CA125, HE4, and ultrasound findings, ROMA and RMI indexes were determined for each patient, and the sensitivity and specificity of HE4, RMI, ROMA, and CA125 were compared with the result of the operative histopathologic assessment.
Results: According to the area under the ROC curve, regardless of the patients' menopausal status, the highest diagnostic value was dedicated to RMI with 89% under the curve area and 95% confidence interval (81.6-96.4%). Diagnostic values of other markers were as the following: 87.7%(95%CI=80.3-95%) for HE4, 87.3(95%CI=79.1-95.4%) for CA125, and 86.2%(95%CI=78.7-93.6%) for ROMA. In terms of menopausal status, HE4 had the highest diagnostic value in premenopausal patients, while in the menopausal group CA125 had the highest diagnostic value.
Conclusion: Measurement of HE4 before menopause and CA125 during menopause seems to be helpful in the early detection of ovarian cancers in women with ovarian masses.
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Type of Study: Original Article |

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