A novel diagnostic index combining HE4, CA125 and age may improve triage of women with suspected ovarian cancer - An international multicenter study in women with an ovarian mass
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A novel diagnostic index combining HE4, CA125 and age may improve triage of women with suspected ovarian cancer - An international multicenter study in women with an ovarian mass. / Karlsen, Mona Aarenstrup; Høgdall, Estrid V S; Christensen, Ib J; Borgfeldt, Christer; Kalapotharakos, Grigorios; Zdrazilova-Dubska, Lenka; Chovanec, Josef; Lok, Christianne A R; Stiekema, Anna; Mutz-Dehbalaie, Irene; Rosenthal, Adam N; Moore, Elizabeth K; Schodin, Beth A; Sumpaico, Walfrido W; Sundfeldt, Karin; Kristjansdottir, Björg; Zapardiel, Ignacio; Høgdall, Claus K.
I: Gynecologic Oncology, Bind 138, Nr. 3, 09.2015, s. 640-6.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - A novel diagnostic index combining HE4, CA125 and age may improve triage of women with suspected ovarian cancer - An international multicenter study in women with an ovarian mass
AU - Karlsen, Mona Aarenstrup
AU - Høgdall, Estrid V S
AU - Christensen, Ib J
AU - Borgfeldt, Christer
AU - Kalapotharakos, Grigorios
AU - Zdrazilova-Dubska, Lenka
AU - Chovanec, Josef
AU - Lok, Christianne A R
AU - Stiekema, Anna
AU - Mutz-Dehbalaie, Irene
AU - Rosenthal, Adam N
AU - Moore, Elizabeth K
AU - Schodin, Beth A
AU - Sumpaico, Walfrido W
AU - Sundfeldt, Karin
AU - Kristjansdottir, Björg
AU - Zapardiel, Ignacio
AU - Høgdall, Claus K
N1 - Copyright © 2015 Elsevier Inc. All rights reserved.
PY - 2015/9
Y1 - 2015/9
N2 - AIM: To develop and validate a biomarker-based index to optimize referral and diagnosis of patients with suspected ovarian cancer. Furthermore, to compare this new index with the Risk of Malignancy Index (RMI) and Risk of Ovarian Malignancy Algorithm (ROMA).PATIENTS AND METHODS: A training study, consisting of patients with benign ovarian disease (n=809) and ovarian cancer (n=246), was used to develop the Copenhagen Index (CPH-I) utilizing the variables serum HE4, serum CA125 and patient age. Eight international studies provided the validation population; comprising 1060 patients with benign ovarian masses and 550 patients with ovarian cancer.RESULTS: Overall, 2665 patients were included. CPH-I was highly significant in discriminating benign from malignant ovarian disease. At the defined cut-off of 0.070 for CPH-I the sensitivity and specificity were 95.0% and 78.4% respectively in the training cohort and 82.0% and 88.4% in the validation cohort. Comparison of CPH-I, ROMA and RMI demonstrated area-under-curve (AUC) at 0.960, 0.954 and 0.959 respectively in the training study and 0.951, 0.953 and 0.935 respectively in the validation study. Using a sensitivity of 95.0%, the specificities for CPH-I, ROMA and RMI in the training cohort were 78.4%, 71.7% and 81.5% respectively, and in the validation cohort 67.3%, 70.7% and 69.5% respectively.CONCLUSION: All three indices perform well at the clinically relevant sensitivity of 95%, but CPH-I, unlike RMI and ROMA, is independent of ultrasound and menopausal status, and may provide a simple index to optimize referral of women with suspected ovarian cancer.
AB - AIM: To develop and validate a biomarker-based index to optimize referral and diagnosis of patients with suspected ovarian cancer. Furthermore, to compare this new index with the Risk of Malignancy Index (RMI) and Risk of Ovarian Malignancy Algorithm (ROMA).PATIENTS AND METHODS: A training study, consisting of patients with benign ovarian disease (n=809) and ovarian cancer (n=246), was used to develop the Copenhagen Index (CPH-I) utilizing the variables serum HE4, serum CA125 and patient age. Eight international studies provided the validation population; comprising 1060 patients with benign ovarian masses and 550 patients with ovarian cancer.RESULTS: Overall, 2665 patients were included. CPH-I was highly significant in discriminating benign from malignant ovarian disease. At the defined cut-off of 0.070 for CPH-I the sensitivity and specificity were 95.0% and 78.4% respectively in the training cohort and 82.0% and 88.4% in the validation cohort. Comparison of CPH-I, ROMA and RMI demonstrated area-under-curve (AUC) at 0.960, 0.954 and 0.959 respectively in the training study and 0.951, 0.953 and 0.935 respectively in the validation study. Using a sensitivity of 95.0%, the specificities for CPH-I, ROMA and RMI in the training cohort were 78.4%, 71.7% and 81.5% respectively, and in the validation cohort 67.3%, 70.7% and 69.5% respectively.CONCLUSION: All three indices perform well at the clinically relevant sensitivity of 95%, but CPH-I, unlike RMI and ROMA, is independent of ultrasound and menopausal status, and may provide a simple index to optimize referral of women with suspected ovarian cancer.
KW - Adolescent
KW - Adult
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Algorithms
KW - Biomarkers, Tumor
KW - CA-125 Antigen
KW - Cohort Studies
KW - Diagnosis, Differential
KW - Female
KW - Humans
KW - Membrane Proteins
KW - Middle Aged
KW - Models, Statistical
KW - Multivariate Analysis
KW - Ovarian Diseases
KW - Ovarian Neoplasms
KW - Prospective Studies
KW - Proteins
KW - Severity of Illness Index
KW - Young Adult
U2 - 10.1016/j.ygyno.2015.06.021
DO - 10.1016/j.ygyno.2015.06.021
M3 - Journal article
C2 - 26086566
VL - 138
SP - 640
EP - 646
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 3
ER -
ID: 162338597