Clinical Value of Serum HE4, CA125, CA72-4, and ROMA Index for Diagnosis of Ovarian Cancer and Prediction of Postoperative Recurrence

Background: Ovarian cancer is one of the most common cancers among women. With cancer, early detection is paramount to saving lives. However, early detection of ovarian cancer has been fraught with difficulty. The diagnostic performance of HE4, CA125, ROMA index, and CA72-4 was evaluated for ovarian cancer. Methods: This was a diagnostic study enrolling 97 patients with pelvic masses who had been scheduled for surgery and 33 healthy women. Serum levels of tumor markers, including human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125), and carbohydrate antigen 72-4 (CA72-4) were detected in each patient and analyzed using the risk of ovarian malignancy algorithm (ROMA) index for sensitivity, specificity, positive predictive values, negative predictive values, and accuracy. ROC curve analysis was conducted to compare the diagnostic performances of serum HE4, CA125, CA72-4, and ROMA index in ovarian cancer. The dynamic changes of these biomarkers were analyzed in patients with ovarian cancer after operation. Results: HE4 had the best specificity, CA72-4 had the lowest sensitivity, and ROMA index had the best diagnostic efficiency among these biomarkers for diagnosis of ovarian cancer. CA125 had better specificity in the post-menopausal group than in non-menopausal group. The kinetic changes of HE4, CA125, and ROMA index in patients with ovarian cancer were consistent with the remission and recurrence of the disease. Conclusions: HE4 and ROMA index which reference intervals are established according to the menopausal status have important clinical significance in the diagnosis of ovarian cancer. Regular detection of serum HE4, CA125, and ROMA index can help predict postoperative recurrence of ovarian cancer.