Obstet Gynecol Sci.  2016 Jul;59(4):295-302. 10.5468/ogs.2016.59.4.295.

Analysis of falsely elevated risk of ovarian malignancy algorithm in women with ovarian endometrioma

• Shin JJ
• Lee YJ
• Kim R
• Lee DY
• Won KH
• Jee BC

• KMID: 2329050
• DOI: http://doi.org/10.5468/ogs.2016.59.4.295

Abstract

OBJECTIVE
To estimate the incidence of falsely elevated risk of ovarian malignancy algorithm (ROMA) in a group of women with pathologically confirmed endometrioma and to investigate the associated factors.
METHODS
One hundred premenopausal women surgically diagnosed with ovarian endometrioma were selected. Preoperative clinical, laboratory, and surgical characteristics were compared between the elevated-risk group (ROMA-premenopausal value, ≥7.4%) and normal-risk group (ROMA-premenopausal value, <7.4%).
RESULTS
Elevated ROMA was observed in 15 women (false positive rate, 15%). Excluding one woman with known chronic renal failure, we compared the characteristics of 99 women between the elevated-risk group (n=14) and the normalrisk group (n=85). None of the clinical and surgical variables distinguished the two groups. Serum level of CA 125 >82.3 U/mL and serum level of human epididymis protein 4 (HE4) >46 pmol/L could predict an elevated ROMA test with a statistical significance. When serum level of HE4 ≤46 pmol/L, none of the women showed an elevated ROMA test, regardless of serum level of CA 125; however, 55.6% of the women showed an elevated ROMA test when serum level of HE4 >46 pmol/L and CA 125 ≤82.3 U/mL and all women showed an elevated ROMA test when serum level of HE4 >46 pmol/L and CA 125 >82.3 U/mL.
CONCLUSION
The incidence of falsely elevated ROMA was 15% in the group of women with pathologically confirmed endometrioma. Interpretation of the ROMA results should be cautious when serum level of HE4 >46 pmol/L and CA 125 >82.3 U/mL in women with suspicious ovarian endometrioma.

Keyword

Endometriosis; False positive; Risk of ovarian malignancy algorithm

MeSH Terms

Endometriosis*
Epididymis
Female
Humans
Incidence
Kidney Failure, Chronic
Male
Roma

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