title: The Risk of Ovarian Malignancy Algorithm (ROMA) as a Predictive Marker of Peritoneal Dissemination in Epithelial Ovarian Cancer Patients.
abstract: BACKGROUND
  This study aimed to determine the efficacy of the risk of ovarian malignancy algorithm (ROMA), calculated using the carbohydrate antigen 125 (CA125) and human epididymis protein 4 (HE4) levels and the menopausal status, as a predictor of peritoneal dissemination in ovarian cancer.
  
  
  METHODS
  The CA125 and HE4 levels and the ROMA were compared between ovarian cancer patients (n = 122) with or without peritoneal dissemination. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated, and the results were compared with those of computed tomography (CT).
  
  
  RESULTS
  The CA125, HE4, and ROMA values differed significantly depending on the presence of peritoneal dissemination (p < 0.0001). The cut-off values were 181 U/ml for CA125, 161 pmol/ml for HE4, 44% for the ROMA (premenopausal), and 86% for the ROMA (postmenopausal). Among these markers, the ROMA (premenopausal) was the strongest predictor of peritoneal dissemination, with a specificity of 85.0% and a positive predictive value of 81.3%. In addition, the detection rates of small disseminations with less than 2 cm in diameter for the ROMA (93%) and HE4 (60%) were superior to that of CT (53%).
  
  
  CONCLUSIONS
  The ROMA was a significant predictor of peritoneal dissemination and may be superior to CT for the detection of patients with small disseminations.
authors.affiliation: Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Kosei
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Akira
authors.initials: A
authors.lastname: Kurosaki
authors.forename: Akiko
authors.initials: A
authors.lastname: Miyara
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hanaoka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shintani
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Imai
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Oda
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fujiwara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D000077216:Carcinoma, Ovarian Epithelial; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000556:secondary*; D017698:Postmenopause; D011237:Predictive Value of Tests; D017697:Premenopause; D011506:Proteins / Q000378:metabolism*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human