Clinical Significance Of ROMA Index In The Risk Assessment Of Ovarian Cancer

Objective To study the optimal predictive probability of ROMA index in patients with ovarian cancer in Ningxia region and to explore the clinical performance of ROMA index in ovarian cancer risk assessment in Ningxia region.Methods This study analyzed a total of 288 patients who were admitted to the hospital with pelvic masses and underwent surgical treatment from January2015 to October 2016 at the General Hospital of Ningxia Medical University.The levels of serum HE4 and CA125 in healthy controls and ovarian cancer patients were measured by Roche cobas e602 electrochemiluminescence immunoassay analyzer.Calculating ROMA Index and ROMA Predicted Probability threshold of risk Assessment,combined with menopausal status assessment of patients suffering from ovarian cancer risk.Results The levels of serum CA125,HE4 and ROMA index were 302.60(104.69-595.03)U/ml,222.65(116.38-485.30)pmol/L,and 83.85(58.89-95.46)%respectively in the malignant tumor group,which were higher than those in the healthy control group and benign tumor group(P < 0.01).The CA125 level in the benign ovarian tumor group was significantly higher than that in the healthy control group(P < 0.01).The optimal predictive probability of ROMA index was9.96% for premenopausal and 43.35% for postmenopausal.The sensitivity of serum CA125,HE4,ROMA index was 88.2%,66.2%,83.8% for premenopausal,respectively.The postmenopausal were 89.8%,75.0%,93.2%.And the specificity were 69.6%,100%,and 80.1%,for premenopausal,respectively.The postmenopausal were 85.0%,100%,95.0%.The area under the ROC curve was 0.854,0.886,0.896 before menopause,and 0.952,0.953,0.958 after menopause.The correct rate of classification of ovarian cancer patients with serous cystadenocarcinoma,mucinous cystadenocarcinoma,endometrioid carcinoma,and non-epithelial adenocarcinoma into high-risk groups was 996.56%,94.44%,66.67%,73.33% for premenopausal,there was a statistically significant difference in the correct rate between ovarian serous cystadenocarcinoma and non-epithelial adenocarcinoma(P< 0.05);the correct rate of classification of postmenopausal patients into high-risk groups was not statistically different(P>0.05).Before and after menopause,the correct rate of patients with stage I/II and stage III/IV was classified into high-risk group,with no statistically significant difference(P>0.05).Conclusion The differential diagnosis of benign and malignant ovarian tumors,HE4,ROMA index are better than CA125,suggesting that HE4,ROMA index in the diagnosis of ovarian benign and malignant tumors and screening high risk ovarian cancer patients have a higher clinical value.Calculating the optimal cut-off value of ROMA index before and after menopause can significantly improve the sensitivity and specificity of ROMA model for ovarian cancer risk assessment,and improve the accuracy of preoperative assessment of risk of ovarian cancer in premenopausal or postmenopausal women with pelvic masses.For patients with different pathological types and different clinical stages of epithelial ovarian cancer,the ROMA model can accurately assess ovarian cancer risk.It is suggested that ROMA model can correctly and accurately classify women with pelvic masses,and has a certain guiding significance for risk assessment of ovarian cancer.