The Performance of HE4 Alone and in Combination with CA125 for the Detection of Ovarian Cancer in an Enriched Primary Care Population.
CA125
HE4
ROMA
biomarker
early detection
ovarian cancer
primary care
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
24 Apr 2022
24 Apr 2022
Historique:
received:
17
03
2022
revised:
12
04
2022
accepted:
19
04
2022
entrez:
14
5
2022
pubmed:
15
5
2022
medline:
15
5
2022
Statut:
epublish
Résumé
Human epididymis 4 (HE4) is a promising ovarian cancer biomarker, but it has not been evaluated in primary care. In this prospective observational study, we investigated the diagnostic accuracy of HE4 alone and in combination with CA125 for the detection of ovarian cancer in symptomatic women attending primary care. General practitioner (GP)-requested CA125 samples were tested for HE4 at a large teaching hospital in Manchester, and cancer outcomes were tracked for 12 months. We found a low incidence of ovarian cancer in primary care; thus, the cohort was enriched with pre-surgical samples from 81 ovarian cancer patients. The Risk of Ovarian Malignancy Algorithm (ROMA) was calculated using age (</>51) as a surrogate for menopause. Conventional diagnostic accuracy metrics were determined. A total of 1229 patients were included; 82 had ovarian cancer. Overall, ROMA performed best (AUC-0.96 (95%CI: 0.94−0.98, p = <0.001)). In women under 50 years, the combination of CA125 and HE4 (either marker positive) was superior (sensitivity: 100% (95%CI: 81.5−100.0), specificity: 80.1% (95%CI 76.7−83.1)). In women over 50, ROMA performed best (sensitivity: 84.4% (95%CI: 73.1−92.2), specificity: 87.2% (95%CI 84.1−90)). HE4 and ROMA may improve ovarian cancer detection in primary care, particularly for women under 50 years, in whom diagnosis is challenging. Validation in a larger primary care cohort is required.
Identifiants
pubmed: 35565253
pii: cancers14092124
doi: 10.3390/cancers14092124
pmc: PMC9101616
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Wellbeing of Women
ID : ELS701
Organisme : Wellbeing of Women
ID : RTF707
Organisme : National Institute for Health Research
ID : IS-BRC-1215-20007
Organisme : National Institute for Health Research
ID : NIHR300650
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