899P - Risk of ovarian malignancy algorithm in the preoperative diagnosing of patients with ovarian tumors

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Ovarian Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Lukasz Janas
Citation Annals of Oncology (2014) 25 (suppl_4): iv305-iv326. 10.1093/annonc/mdu338
Authors L. Janas1, E. Glowacka1, J. Wilczynski1, A. Malinowski2, M. Nowak1
  • 1Department Of Gynecology And Gynecological Oncology, Polish Mother’s Memorial Hospital – Research Institute, 93-338 - Lodz/PL
  • 2Department Of Operative, Endoscopic And Oncological Gynecology, Polish Mother’s Memorial Hospital – Research Institute, 93-338 - Lodz/PL



The purpose of the study was to evaluate the utility of Human Epididymis Protein 4 (HE4) and Risk of Ovarian Malignancy Algorithm (ROMA) in a preoparative diagnosis of ovarian malignancies.


Serum samples were collected from 223 women with pelvic mass (114 pre- and 109 postmenopausal), who were admitted to gynecological ward and qualified for explorative surgery. 48 patients suffered from malignant tumors (36 primary ovarian cancers, 12 metastases to the ovaries) and 6 – from borderline tumors. 164 women had benign ovarian tumors (including 37 cases of endometriosis). In 5 patients pelvic mass occurred to be myomas of the uterus. Serum samples were analyzed to determine the levels of HE4 and CA125 and ROMA was calculated. Results were compared with pathological findings.


The levels of both CA125 and HE4 were significantly elevated in sera of women with ovarian malignancies versus benign disease. CA125 reached the sensitivity of 83.3% at the specificity of 70.9%. HE4 showed the sensitivity of 89.6% at the specificity of 81.1%. The combination of both markers (ROMA) achieved the sensitivity of 87.5% at the specificity of 80.0%. Patients with endometriosis had significantly higher levels of serum CA125 than women with other nonmalignant ovarian tumors. Levels of HE4 did not differ between these groups.


Serum levels HE4, CA125 and ROMA proved to be useful in preoperative identification of the character of ovarian tumors. Adding HE4 to the protocol improves diagnostics in cases of endometriosis, verifying false positive results of CA125.


All authors have declared no conflicts of interest.