Value Analysis Of CPH-I、RMI And ROMA In EOC Preoperative Diagnosis

Background:Epithelial ovarian cancer is a common gynecological tumor disease,which is divided into serous adenocarcinoma,mucinous adenocarcinoma,endometrial adenocarcinoma,clear cell carcinoma,small cell carcinoma and undifferentiated carcinoma.EOC preliminary diagnosis usually depends on the measurement of relevant tumor markers and ultrasound examination,and there is no effective ovarian cancer screening program.CPH-I,RMI,ROMA and many other indicators in the evaluation of epithelial ovarian tumors have high sensitivity and specificity.They are an ideal method for evaluating epithelial ovarian cancer.Compare and analyze the diagnostic value of these three indexes.It is of great significance for the preoperative diagnosis of EOC.Objective:Hope to provide a theoretical basis for clinical workers to make better judgment before operation,to make the best medical decision in clinic,and to provide sufficient clinical data for further finding the best index of EOC early diagnosis in the future,so as to guide clinical application.Methods:From August 2019 to August 2020,patients with epithelial ovarian cancer were admitted to our hospital(the second Hospital of Jilin University)and diagnosed by routine pathology after operation.The basic information and general clinical data of patients were queried through our hospital medical record system.The diagnosis and treatment of patients were analyzed retrospectively.Results:1.There were 300 subjects in this study,including 150 ovarian tumor malignant the average age was 54.90±10.54 years old,150 benign group,the average age was 50.23±15.88 years old,the age of malignant group was higher than that of benign group,the difference was statistically significant(P=0.003).2.The serum CA125 、 HE4 level and CPH-I 、 RMI I-IV 、 ROMA predictive value of malignant group were higher than that of benign group(P<0.001).3.The sensitivity and negative predictive value of the ROMA index were the highest among the overall patients,which were 81.3% and 83.3%,respectively.CPH-I has the highest specificity and positive predictive value,which are 94.0% and 92.5%.4.The maximum AUC of CPH-I was 0.927,which was higher than the RMI and ROMA index.5.Among the menopausal population,the sensitivity and negative predictive value of RMI-II were the highest,at 87.0% and 86.6%,respectively,but the specificity and positive predictive value were the lowest.6.The AUC of ROMA index and CPH-I in menopausal population were higher than those in the four scoring systems of RMI,0.941 and 0.935,respectively.The AUC of ROMA index higher than that of CPH-I,RMI-I is less than that of each risk index scoring system,which is0.901.7.In the premenopausal population,the sensitivity of the ROMA index is 78%,and the negative predictive value is 81.4%,ranking first.The specificity ranks: CPH-I and RMI I-IV are equal,both are 98%,and both are greater than the ROMA index(96%).8.The area under the ROC curve of CPH-I was larger than that of each risk index scoring system in the unmenopausal population compared with 4 RMI.The area under the ROC curve of ROMA index evaluation was larger than that of each risk index scoring system.There was no significant statistical difference between CPH-I and ROMA index(P>0.05).Conclusion:1.CPH-I、RMI I-IV、ROMA index has higher diagnostic value than other single tumor makers such as CA125 inhibition or HE4 in preoperative diagnosis.2.The CPH-I、RMI I-IV、ROMA index is not recommended as a universal population screening program,and the CPH-I、RMI I-IV、ROMA Index is recommended to evaluate the Results:high risk population with family history and the patients with adnexal mass to be operated on.3.EOC the early effective diagnosis of the patient,the patient can be referred to the gynecological oncology specialty as soon as possible,and the survival benefit can be better under the condition of the professional gynecologic oncologist’s tumor stage or tumor cell reduction.4.CPH-I is more effective in preoperative diagnosis in the EOC of unmenopausal and general population.5.ROMA index is more effective in preoperative diagnosis of menopausal EOC.