Clinical value of serum CA125, CA724, HE4, premenopausal and postmenopausal ROMA index for diagnosis of high-grade serous ovarian cancer

Abstract Background: This study aimed at exploring a panel of novel biomarker for early detection of high-grade serous ovarian cancer (HGSOC). Methods: The serum levels of CA125, CA724 and HE4 were compared among serum samples collected from patients with HGSOC, borderline malignancy or benign gynecologic pathologies. Univariable and multivariable logistic regression analyses were performed to identify the risk factors of HGSOC. Nomogram was established for predicting HGSOC using the risk factors. Receiver operating characteristic (ROC) curves was plotted and the area under the curve (AUC), sensitivity and specificity of the CA125, CA724, HE4, ROMA and new panel were calculated.Results: The serum concentration of CA125, CA724 and HE4 were increased among patients with HGSOC. The AUC of CA125, CA724, HE4, ROMA2 and the new panel based on age, CA125 and ROMA2 were 0.732 (0.646-0.818), 0.773 (0.699-0.847), 0.886 (0.831-0.941), 0.835 (0.763-0.907), and 0.933 (0.896-0.969), respectively. Nomogram was constructed to diagnose HGSOC based on CA125, age and ROMA2. The C-indices of this nomogram was 0.88 (95% CI= 0.81-0.95) in training cohort and 0.91 (95% CI= 0.86-0.96) in the validation cohort. The sensitivity and specificity were 89.66% and 82.44% in diagnosing HGSOC, and the positive predictive value and negative predictive value of new algorithm were 69.33% and 94.74%, respectively.Conclusion: The new index based on age, CA125 and ROMA2 could be a new auxiliary diagnostic indicator in distinguishing HGSOC from borderline malignancy.