Skip to main content
Top
Published in: Clinical and Translational Oncology 10/2017

01-10-2017 | Research Article

Correlation of preoperative ROMA scores with clinical stage in epithelial ovarian cancer patients

Authors: Q.-L Li, C.-J. Wang, P. Qi, Y.-X. Zhang

Published in: Clinical and Translational Oncology | Issue 10/2017

Login to get access

Abstract

Purpose

The significance of the Risk of Ovarian Malignancy Algorithm (ROMA) in differentiating benign and malignant ovarian lesions has been evidenced. In our clinical work, we found that advanced ovarian cancer were accompanied commonly with high ROMA scores. Thus, this study aimed to clarify the performance of ROMA in different disease stage of epithelial ovarian cancer (EOC) prior to surgery.

Methods

Carbohydrate antigen (CA125) and human epididymis protein 4 (HE4) levels and ROMA scores in 221 patients with FIGO stage I, II or III/IV stage EOC were analyzed. The positive rates of CA125, HE4 and ROMA at each disease stage were calculated. Their cutoff values, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for distinguishing patients with FIGO stage I/II from those with FIGO stage III/IV were estimated via ROC curves.

Results

Serum CA125 and HE4 levels and ROMA scores rose significantly with advancing stage. ROMA and CA125 were significantly elevated more frequently in comparing with HE4 in EOC patients at with the same stage. Based on ROC curves, the cutoff values for FIGO stage III/IV EOC were 110 IU/mL, 126 pmol/L, 78 and 68% for CA125, HE4, premenopausal and postmenopausal ROMA, respectively. ROMA was the strongest predictor of FIGO stage, with the highest specificity, accuracy, and PPV, which were 84.4, 82.5, and 87.0% for postmenopausal patients, 89.3, 85.6, and 74.3% for premenopausal patients.

Conclusions

Our data suggest high ROMA scores correlated with advanced ovarian cancer prior to surgery. These observations suggest potential utility of ROMA in the comprehensively preoperative evaluation of EOC patients.
Literature
1.
2.
go back to reference De Angelis R, Sant M, Coleman MP, Francisci S, Baili P, Pierannunzio D, et al. Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE − 5-a population-based study. Lancet Oncol. 2014;15(1):23–34.CrossRefPubMed De Angelis R, Sant M, Coleman MP, Francisci S, Baili P, Pierannunzio D, et al. Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE − 5-a population-based study. Lancet Oncol. 2014;15(1):23–34.CrossRefPubMed
3.
go back to reference Bast RC Jr, Feeney M, Lazarus H, Nadler LM, Colvin RB, Knapp RC. Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest. 1981;68(5):1331–7.CrossRefPubMedPubMedCentral Bast RC Jr, Feeney M, Lazarus H, Nadler LM, Colvin RB, Knapp RC. Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest. 1981;68(5):1331–7.CrossRefPubMedPubMedCentral
4.
go back to reference Tholander B, Taube A, Lindgren A, Sjöberg O, Stendahl U, Tamsen L. Pretreatment serum levels of CA-125, carcinoembryonic antigen, tissue polypeptide antigen, and placental alkaline phosphatase in patients with ovarian carcinoma: influence of histological type, grade of differentiation, and clinical stage of disease. Gynecol Oncol. 1990;39(1):26–33.CrossRefPubMed Tholander B, Taube A, Lindgren A, Sjöberg O, Stendahl U, Tamsen L. Pretreatment serum levels of CA-125, carcinoembryonic antigen, tissue polypeptide antigen, and placental alkaline phosphatase in patients with ovarian carcinoma: influence of histological type, grade of differentiation, and clinical stage of disease. Gynecol Oncol. 1990;39(1):26–33.CrossRefPubMed
6.
go back to reference Escudero JM, Auge JM, Filella X, Torne A, Pahisa J, Molina R. Comparison of serum human epididymis protein 4 with cancer antigen 125 as a tumor marker in patients with malignant and nonmalignant diseases. Clin Chem. 2011;57(11):1534–44.CrossRefPubMed Escudero JM, Auge JM, Filella X, Torne A, Pahisa J, Molina R. Comparison of serum human epididymis protein 4 with cancer antigen 125 as a tumor marker in patients with malignant and nonmalignant diseases. Clin Chem. 2011;57(11):1534–44.CrossRefPubMed
7.
go back to reference Trudel D, Têtu B, Grégoire J, Plante M, Renaud MC, Bachvarov D, et al. Human epididymis protein 4 (HE4) and ovarian cancer prognosis. Gynecol Oncol. 2012;127(3):511–5.CrossRefPubMed Trudel D, Têtu B, Grégoire J, Plante M, Renaud MC, Bachvarov D, et al. Human epididymis protein 4 (HE4) and ovarian cancer prognosis. Gynecol Oncol. 2012;127(3):511–5.CrossRefPubMed
8.
go back to reference Bouchard D, Morisset D, Bourbonnais Y, Tremblay GM. Proteins with wheyacidic-protein motifs and cancer. Lancet Oncol. 2006;7(2):167–74.CrossRefPubMed Bouchard D, Morisset D, Bourbonnais Y, Tremblay GM. Proteins with wheyacidic-protein motifs and cancer. Lancet Oncol. 2006;7(2):167–74.CrossRefPubMed
9.
go back to reference Moore RG, Miller MC, Steinhoff MM, Skates SJ, Lu KH, Lambert-Messerlian G, et al. Serum HE4 levels are less frequently elevated than CA 125 in women with benign gynecological disorders. Am J Obstet Gynecol. 2012;206(4):351.e1–8.CrossRef Moore RG, Miller MC, Steinhoff MM, Skates SJ, Lu KH, Lambert-Messerlian G, et al. Serum HE4 levels are less frequently elevated than CA 125 in women with benign gynecological disorders. Am J Obstet Gynecol. 2012;206(4):351.e1–8.CrossRef
10.
go back to reference Wu L, Dai ZY, Qian YH, Shi Y, Liu FJ, Yang C. Diagnostic value of serum human epididymis protein 4 (HE4) in ovarian carcinoma: a systematic review and meta-analysis. Int J Gynecol Cancer. 2012;22(7):1106–12.CrossRefPubMed Wu L, Dai ZY, Qian YH, Shi Y, Liu FJ, Yang C. Diagnostic value of serum human epididymis protein 4 (HE4) in ovarian carcinoma: a systematic review and meta-analysis. Int J Gynecol Cancer. 2012;22(7):1106–12.CrossRefPubMed
11.
go back to reference Holcomb K, Vucetic Z, Miller MC, Knapp RC. Human epididymis protein 4 offers superior specificity in the differentiation of benign and malignant adnexal masses in premenopausal women. Am J Obstet Gynecol. 2011;205(4):358.e1–6.CrossRef Holcomb K, Vucetic Z, Miller MC, Knapp RC. Human epididymis protein 4 offers superior specificity in the differentiation of benign and malignant adnexal masses in premenopausal women. Am J Obstet Gynecol. 2011;205(4):358.e1–6.CrossRef
12.
go back to reference Hallamaa M, Suvitie P, Huhtinen K, Matomäki J, Poutanen M, Perheentupa A. Serum HE4 concentration is not dependent on menstrual cycle or hormonal treatment among endometriosis patients and healthy premenopausal women. Gynecol Oncol. 2012;125(3):667–72.CrossRefPubMed Hallamaa M, Suvitie P, Huhtinen K, Matomäki J, Poutanen M, Perheentupa A. Serum HE4 concentration is not dependent on menstrual cycle or hormonal treatment among endometriosis patients and healthy premenopausal women. Gynecol Oncol. 2012;125(3):667–72.CrossRefPubMed
13.
go back to reference Moore RG, McMeekin DS, Brown AK, DiSilvestro P, Miller MC, Allard WJ, et al. A novel multiple marker bioassay utilizing HE4 and CA125 for the prediction of ovarian cancer in patients with a pelvic mass. Gynecol Oncol. 2009;112(1):40–6.CrossRefPubMed Moore RG, McMeekin DS, Brown AK, DiSilvestro P, Miller MC, Allard WJ, et al. A novel multiple marker bioassay utilizing HE4 and CA125 for the prediction of ovarian cancer in patients with a pelvic mass. Gynecol Oncol. 2009;112(1):40–6.CrossRefPubMed
14.
go back to reference Moore RG, Miller MC, Disilvestro P, Landrum LM, Gajewski W, Ball JJ, et al. Evaluation of the diagnostic accuracy of the risk of ovarian malignancy algorithm in women with a pelvic mass. Obstet Gynecol. 2011;118(2 Pt 1):280–8.CrossRefPubMedPubMedCentral Moore RG, Miller MC, Disilvestro P, Landrum LM, Gajewski W, Ball JJ, et al. Evaluation of the diagnostic accuracy of the risk of ovarian malignancy algorithm in women with a pelvic mass. Obstet Gynecol. 2011;118(2 Pt 1):280–8.CrossRefPubMedPubMedCentral
15.
16.
go back to reference Kadija S, Stefanovic A, Jeremic K, Radojevic MM, Nikolic L, Markovic I, et al. The utility of human epididymal protein 4, cancer antigen 125, and risk for malignancy algorithm in ovarian cancer and endometriosis. Int J Gynecol Cancer. 2012;22(2):238–44.CrossRefPubMed Kadija S, Stefanovic A, Jeremic K, Radojevic MM, Nikolic L, Markovic I, et al. The utility of human epididymal protein 4, cancer antigen 125, and risk for malignancy algorithm in ovarian cancer and endometriosis. Int J Gynecol Cancer. 2012;22(2):238–44.CrossRefPubMed
17.
go back to reference Lokich E, Palisoul M, Romano N, Craig Miller M, Robison K, Stuckey A, et al. Assessing the risk of ovarian malignancy algorithm for the conservative management of women with a pelvic mass. Gynecol Oncol. 2015;139(2):248–52.CrossRefPubMedPubMedCentral Lokich E, Palisoul M, Romano N, Craig Miller M, Robison K, Stuckey A, et al. Assessing the risk of ovarian malignancy algorithm for the conservative management of women with a pelvic mass. Gynecol Oncol. 2015;139(2):248–52.CrossRefPubMedPubMedCentral
18.
go back to reference Fujiwara H, Suzuki M, Takeshima N, Takizawa K, Kimura E, Nakanishi T, et al. Evaluation of human epididymis protein 4 (HE4) and Risk of Ovarian Malignancy Algorithm (ROMA) as diagnostic tools of type I and type II epithelial ovarian cancer in Japanese women. Tumour Biol. 2015;36(2):1045–53.CrossRefPubMed Fujiwara H, Suzuki M, Takeshima N, Takizawa K, Kimura E, Nakanishi T, et al. Evaluation of human epididymis protein 4 (HE4) and Risk of Ovarian Malignancy Algorithm (ROMA) as diagnostic tools of type I and type II epithelial ovarian cancer in Japanese women. Tumour Biol. 2015;36(2):1045–53.CrossRefPubMed
19.
go back to reference Romagnolo C, Leon AE, Fabricio AS, Taborelli M, Polesel J, Del Pup L, et al. HE4, CA125 and risk of ovarian malignancy algorithm (ROMA) as diagnostic tools for ovarian cancer in patients with a pelvic mass: an Italian multicenter study. Gynecol Oncol. 2016;141(2):303–11.CrossRefPubMed Romagnolo C, Leon AE, Fabricio AS, Taborelli M, Polesel J, Del Pup L, et al. HE4, CA125 and risk of ovarian malignancy algorithm (ROMA) as diagnostic tools for ovarian cancer in patients with a pelvic mass: an Italian multicenter study. Gynecol Oncol. 2016;141(2):303–11.CrossRefPubMed
20.
go back to reference Drapkin R, von Horsten HH, Lin Y, Mok SC, Crum CP, Welch WR, et al. Human epididymis protein 4 (HE4) is a secreted glycoprotein that is overexpressed by serous and endometrioid ovarian carcinomas. Cancer Res. 2005;65(6):2162–9.CrossRefPubMed Drapkin R, von Horsten HH, Lin Y, Mok SC, Crum CP, Welch WR, et al. Human epididymis protein 4 (HE4) is a secreted glycoprotein that is overexpressed by serous and endometrioid ovarian carcinomas. Cancer Res. 2005;65(6):2162–9.CrossRefPubMed
21.
go back to reference Zou SL, Chang XH, Ye X, Cheng HY, Cheng YX, Tang ZJ, et al. Effect of human epididymis protein 4 gene silencing on the malignant phenotype in ovarian cancer. Chin Med J. 2011;124(19):3133–40.PubMed Zou SL, Chang XH, Ye X, Cheng HY, Cheng YX, Tang ZJ, et al. Effect of human epididymis protein 4 gene silencing on the malignant phenotype in ovarian cancer. Chin Med J. 2011;124(19):3133–40.PubMed
22.
23.
go back to reference Holman LL, Lu KH, Bast RC, Hernandez MA, Bodurka DC, Skates S, et al. Risk perception, worry, and test acceptance in average-risk women who undergo ovarian cancer screening. Am J Obstet Gynecol. 2014;210(3):257.e1–6.CrossRef Holman LL, Lu KH, Bast RC, Hernandez MA, Bodurka DC, Skates S, et al. Risk perception, worry, and test acceptance in average-risk women who undergo ovarian cancer screening. Am J Obstet Gynecol. 2014;210(3):257.e1–6.CrossRef
24.
go back to reference Moore RG, Miller MC, Eklund EE, Lu KH, Bast RC Jr, Lambert-Messerlian G. Serum levels of the ovarian cancer biomarker HE4 are decreased in pregnancy and increase with age. Am J Obstet Gynecol. 2012;206(4):349.e1–7.CrossRef Moore RG, Miller MC, Eklund EE, Lu KH, Bast RC Jr, Lambert-Messerlian G. Serum levels of the ovarian cancer biomarker HE4 are decreased in pregnancy and increase with age. Am J Obstet Gynecol. 2012;206(4):349.e1–7.CrossRef
25.
go back to reference Tian Y, Wang C, Cheng L, Zhang A, Liu W, Guo L, et al. Determination of reference intervals of serum levels of human epididymis protein 4 (HE4) in Chinese women. J Ovarian Res. 2015;. doi:10.1186/s13048-015-0201-z. Tian Y, Wang C, Cheng L, Zhang A, Liu W, Guo L, et al. Determination of reference intervals of serum levels of human epididymis protein 4 (HE4) in Chinese women. J Ovarian Res. 2015;. doi:10.​1186/​s13048-015-0201-z.
26.
go back to reference Kappelmayer J, Antal-Szalmás P, Nagy B Jr. Human epididymis protein 4 (HE4) in laboratory medicine and an algorithm in renal disorders. Clin Chim Acta. 2015;438:35–42.CrossRefPubMed Kappelmayer J, Antal-Szalmás P, Nagy B Jr. Human epididymis protein 4 (HE4) in laboratory medicine and an algorithm in renal disorders. Clin Chim Acta. 2015;438:35–42.CrossRefPubMed
Metadata
Title
Correlation of preoperative ROMA scores with clinical stage in epithelial ovarian cancer patients
Authors
Q.-L Li
C.-J. Wang
P. Qi
Y.-X. Zhang
Publication date
01-10-2017
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 10/2017
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-017-1664-8

Other articles of this Issue 10/2017

Clinical and Translational Oncology 10/2017 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine