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Development of a multimarker assay for differential diagnosis of benign and malignant pelvic masses.
Clin Chim Acta. 2015 Feb 02; 440:57-63.CC

Abstract

BACKGROUND

HE4, a novel tumor marker for detecting ovarian cancer, has been recently applied to clinical practice. However, the comprehensive evaluation of HE4 combined with other markers is still missing. We evaluated an optimal mode of HE4 employment for differential diagnosis of benign and malignant pelvic masses.

METHODS

Serum HE4, CA125, CA153, CA199, CA211 and CA724 were measured from 232 patients with pelvic messes (100 malignant masses, 132 benign diseases), and the risk of ovarian malignancy algorithm (ROMA) was also calculated. Receiver operating characteristic curves (ROC), the area under the curve (AUC), sensitivity and specificity were estimated.

RESULTS

The combination of HE4 and CA125 (AUC of 0.963, sensitivity of 96.6%, specificity of 65.7%) provided the best differential power in diagnosing ovarian cancer. ROMA performed better in the diagnosis of pelvic masses (AUC of 0.917, sensitivity of 82.0%, specificity of 78.8%) and uterine cancer (AUC of 0.838, sensitivity of 82.0%, specificity of 60.0%) compared with applying HE4 and CA125 individually.

CONCLUSION

The optimal cut-off values (CA125: 93.2U/ml, HE4: 87.6 pmol/l, ROMA: 18.1% for pre- and 31.5% for postmenopausal women), simultaneous use of CA125 and HE4 complemented by ROMA showed better performance than the traditional detection modes for differential diagnosis of ovarian cancer. We also observed that ROMA added more accuracy for differentiating the benign and malignant pelvic masses and auxiliary diagnosis of uterine cancer.

Authors+Show Affiliations

Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China.Department of Gynaecology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China.Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China.Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China.Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China.Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China.Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China.Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China.Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China.Department of Clinical Laboratory, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong 510080, PR China. Electronic address: 327444677@qq.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25447698

Citation

Chen, Xinliang, et al. "Development of a Multimarker Assay for Differential Diagnosis of Benign and Malignant Pelvic Masses." Clinica Chimica Acta; International Journal of Clinical Chemistry, vol. 440, 2015, pp. 57-63.
Chen X, Zhou H, Chen R, et al. Development of a multimarker assay for differential diagnosis of benign and malignant pelvic masses. Clin Chim Acta. 2015;440:57-63.
Chen, X., Zhou, H., Chen, R., He, J., Wang, Y., Huang, L., Sun, L., Duan, C., Luo, X., & Yan, H. (2015). Development of a multimarker assay for differential diagnosis of benign and malignant pelvic masses. Clinica Chimica Acta; International Journal of Clinical Chemistry, 440, 57-63. https://doi.org/10.1016/j.cca.2014.11.013
Chen X, et al. Development of a Multimarker Assay for Differential Diagnosis of Benign and Malignant Pelvic Masses. Clin Chim Acta. 2015 Feb 2;440:57-63. PubMed PMID: 25447698.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Development of a multimarker assay for differential diagnosis of benign and malignant pelvic masses. AU - Chen,Xinliang, AU - Zhou,Hui, AU - Chen,Rui, AU - He,Jian, AU - Wang,Ying, AU - Huang,Lisi, AU - Sun,Longqiaozi, AU - Duan,Chaohui, AU - Luo,Xiaohong, AU - Yan,Haiyan, Y1 - 2014/11/15/ PY - 2014/06/30/received PY - 2014/10/27/revised PY - 2014/11/13/accepted PY - 2014/12/3/entrez PY - 2014/12/3/pubmed PY - 2015/10/6/medline KW - HE4 KW - Ovarian cancer KW - Pelvic mass KW - ROMA KW - Tumor markers KW - Uterine cancer SP - 57 EP - 63 JF - Clinica chimica acta; international journal of clinical chemistry JO - Clin Chim Acta VL - 440 N2 - BACKGROUND: HE4, a novel tumor marker for detecting ovarian cancer, has been recently applied to clinical practice. However, the comprehensive evaluation of HE4 combined with other markers is still missing. We evaluated an optimal mode of HE4 employment for differential diagnosis of benign and malignant pelvic masses. METHODS: Serum HE4, CA125, CA153, CA199, CA211 and CA724 were measured from 232 patients with pelvic messes (100 malignant masses, 132 benign diseases), and the risk of ovarian malignancy algorithm (ROMA) was also calculated. Receiver operating characteristic curves (ROC), the area under the curve (AUC), sensitivity and specificity were estimated. RESULTS: The combination of HE4 and CA125 (AUC of 0.963, sensitivity of 96.6%, specificity of 65.7%) provided the best differential power in diagnosing ovarian cancer. ROMA performed better in the diagnosis of pelvic masses (AUC of 0.917, sensitivity of 82.0%, specificity of 78.8%) and uterine cancer (AUC of 0.838, sensitivity of 82.0%, specificity of 60.0%) compared with applying HE4 and CA125 individually. CONCLUSION: The optimal cut-off values (CA125: 93.2U/ml, HE4: 87.6 pmol/l, ROMA: 18.1% for pre- and 31.5% for postmenopausal women), simultaneous use of CA125 and HE4 complemented by ROMA showed better performance than the traditional detection modes for differential diagnosis of ovarian cancer. We also observed that ROMA added more accuracy for differentiating the benign and malignant pelvic masses and auxiliary diagnosis of uterine cancer. SN - 1873-3492 UR - https://www.unboundmedicine.com/medline/citation/25447698/Development_of_a_multimarker_assay_for_differential_diagnosis_of_benign_and_malignant_pelvic_masses_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0009-8981(14)00505-1 DB - PRIME DP - Unbound Medicine ER -