Roman index - An effective diagnostic tool for ovarian cancer

This is an automatically translated article.

The article was written by MSc Tran Thi Huyen Trang - Laboratory Doctor, Laboratory Department - Vinmec Times City International General Hospital
Ovarian cancer - "The silent killer". Ovarian cancer is one of the most common genital cancers in women globally, accounting for about 30% of gynecological cancers.

1. What is ovarian cancer?

Every year around the world, there are 204,000 new cases of cancer in women, ranking 7th in cancer deaths in women with 125,000 deaths/year. However, the symptoms of the disease are not clear, progress silently and are often detected at a late stage.

Ung thư buồng trứng đứng thứ 7 trong các loại ung thư gây tử vong ở phụ nữ
Ung thư buồng trứng đứng thứ 7 trong các loại ung thư gây tử vong ở phụ nữ

2. CA125 and ovarian cancer


CA 125 is a glycoprotein derived from the paramesonephric paramesonephric tubules (fallopian tubes, endometrium, and upper vagina) and mesothelial cells (pleura, pericardium, and peritoneum). CA125 promotes cancer cell growth, inhibits antitumor immune response.
CA125 is elevated in ovarian tumors of epithelial origin, benign gynecological diseases (ovarian cysts and endometriosis), malignancies (endometrium, breast, gastrointestinal tract), pathology benign (pancreatitis, cirrhosis, hepatitis, benign gastrointestinal diseases, kidney failure), pregnancy...

3. HE4 test in ovarian cancer


HE4 (Human Epididymal Protein 4) is a marker in ovarian cancer, it has been shown to be involved in the development and invasion of ovarian cancer. HE4 belongs to the group of protease inhibitors, involved in immune function.
HE-4 is found mainly in the female reproductive tissues, epididymis, and vas deferens in the male reproductive system, and is also found in the epithelium of the respiratory tract, distal renal tubules, salivary glands, and colonic mucosa with different concentrations.

Xét nghiệm HE4 là một phương pháp giúp phát hiện sớm bệnh ung thư buồng trứng
Xét nghiệm HE4 là một phương pháp giúp phát hiện sớm bệnh ung thư buồng trứng

4. Roma Index


Roma Index – a combination of CA 125, HE4 and a patient's menstrual status to calculate ovarian cancer risk.
In pelvic tumor risk assessment, if CA 125 alone is not sensitive or specific enough to detect ovarian cancer because:
CA 125 is not elevated in > 50% of cases of ovarian carcinoma early stage (low sensitivity in early stage) CA 125 is elevated in many benign gynecological diseases (low specificity) CA 125 is not elevated in ~20-30% of ovarian cancers When combined with testing HE4 in the diagnosis and monitoring of patients with ovarian cancer increases ovarian cancer detection by 10% and more accurately identifies patients with advanced or recurrent disease than CA 125 alone.
HE4 increased only in patients with ovarian carcinoma and not in healthy controls or in endometriosis HE4 was not increased in most benign gynecological conditions including endometriosis and ovarian cysts egg

Sơ đồ đánh giá chỉ số ROMA ở bệnh nhân có khối u vùng chậu
Sơ đồ đánh giá chỉ số ROMA ở bệnh nhân có khối u vùng chậu

HE4 may better detect stage I/II ovarian cancer than CA 125 alone CA 125 does not always correlate with recurrence, HE4 identifies 25% more patients with relapse where CA 125 misses ROMA least increase in benign gynecological disease when compared with CA 125 or HE4 ROMA alone improves pelvic tumor risk assessment, sensitivity and specificity for differentiating ovarian cancer from benign disease than using CA 125 alone, Vinmec International General Hospital provides female customers with a basic gynecological screening package to help customers check their gynecological function. Carry out necessary tests to help detect early diseases: cervical - uterine - ovarian cancer even when there are no symptoms.

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