수술 후 영상적 종양 아형에 따른 양성 및 조기 악성 난소 종양의 감별 도구로서 ROMA 검사와 CA 125의 비교

Abstract

Objective: To compare the accuracy of the ROMA (risk of ovarian malignancy algorithm) and cancer antigen (CA) 125 as tools to discriminate between benign ovarian tumor and early-stage ovarian cancer according to tumor subtypes diagnosed by imaging and postoperative histopathologic findings. Materials and Methods: A total of 1207 patients were identified who underwent ROMA test due to suspicion of early-stage ovarian cancer and underwent surgery at Asan Medical Center from September 2014 to March 2018. A total of 981 patients who met inclusion criteria were included in the retrospective analysis. Results: Among 981 study patients, 816 had benign tumors and 165 had malignant tumors, including borderline tumors. Among patients diagnosed with ovarian cancer or borderline tumor, 47.3% was judged as high risk by the ROMA test, and 58.2% showed CA125 over 35 U/ml. Specificity and accuracy of ROMA were higher than those of CA125 in premenopausal women. However, the superiority of the ROMA test in discrimination of malignant ovarian tumors compared to CA125 was observed only in patients with endometriotic type (Net reclassification index 0.379). The comparative advantages were not seen in the other tumor subtypes. Conclusion: In the endometriotic type of ovarian tumor, the superiority of the ROMA test compared to CA125 was confirmed for triage of ovarian tumor. However, sensitivity and specificity were similar as a discriminating tool in other tumor types.