Evaluation of Human Epididymis Protein 4, Risk of Ovarian Malignancy Algorithm, and Risk of Malignancy Index Efficiency for Ameliorating Sensitivity and Specificity for Differentiating Benign from Malignant Adnexal Masses

Abstract Background Inadequacy of effective sensitive and specific screening modalities results in late-stage diagnosis ovarian cancer. Cancer Antigen-125 (CA-125) individually possesses limited specificity for differentiating adnexal masses. The present study aimed to evaluate the Human Epididymis Protein 4 (HE4), Risk Ovarian Malignancy Algorithm (ROMA), Index (RMI) ameliorating sensitivity benign from malignant Materials Methods This was conducted on 96 preoperative women with suspected mass (patients) 48 healthy females without (controls) duration 2 years. Both participants were divided into two groups, pre- postmenopausal. CA-125 HE4 done using commercially available kits. ROMA% RMI calculated. We validated their performances histopathology as gold standard. statistical analysis SPSS 21, Kruskal–Wallis, Tukey's tests. best cutoff points values sensitivity, specificity, positive predictive value (PPV), negative (NPV) also evaluated. Results For masses premenopausal group, PPV, NPV, area under curve (AUC) 93.7%, 78.3%, 65.2%, 96.6%, 0.892 CA-125; 87.5%, 83.7%, 70%, 93.9%, 0.926 HE4; 70.2%, 57.6%, 96.2%, 0.927 ROMA; 68.7%, 86.4%, 86.5%, 0.916 RMI. While postmenopausal AUC 92.3%, 76.4%, 85.7%, 86.6%, 0.907 78.5%, 94%, 95.6%, 80%, 0.955 94.1%, 96%, 88.8%, 0.968 88.4%, 88.2%, 92%, 83.3%, 0.943 Conclusion more specifically a mass, ROMA appear be than CA-125.