| The first partObjectiveTo compare CA125,HE4 and ROMAin assessing malignancy risk of pelvic mass with Meta-analysis.Methods and materialsPubMed,ISI Web of Science,and Cochrane literature were searched until December 2017.All studies included were closely assessed with the QUADAS-2(quality assessment of diagnostic accutacy studies-2).Combine and analyse sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagonistic odd ratio and AUC.ResultsTwenty-eight studies were retrieved.Data of CA125 was retrieved from 16 studies,sensitivity and specificity were 80%and 79%respectively,and AUC was 0.867.Data of HE4 was retrieved from 7 studies,sensitivity and specificity were 77%and 83%respectively,and AUC was 0.889.Data of ROMA was retrieved from 8 studies,sensitivity and specificity were 86%and 77%respectively,and AUC was 0.899.Data of RMI was retrieved from 22 studies,sensitivity and specificity were 81%and 84%respectively,and AUC was 0.906.The second partObjectiveTo assess diagnostic performace of Copenhagen index in differentiating benign and malignant ovarian carcinomaMethods and materialsThe data was analyzed consecutively for 319 patients included 178 benign,19 BOT and 122 malignancies.Pathological histology result is the golden standard.Calculate and analyze sensitivity,specificity and AUC after drawing ROC curves.Evaluate the diagnostic performance of CPH-I in distinguishing ovarian benign and malignant mass.ResultsIn general population,sensitivity and specificity of CA125 are 78%and 88%respectively when differentiating between benign and non-benign(BOT+malignant)mass,those of HE4 are 65%and 98%,CPH-I are 70%and 99%.AUC of CA125,HE4 and CPH-I are 0.871,0.896 and 0.913.The third partObjectiveTo compare CPH-I to CA125,HE4,ROMA and RMI in differentiating between benign and malignant ovarian tumorMethods and materialsThe data was analyzed from 178 benign tumors,19 BOT and 122 malignant tumors.Calculate sensitivity,specificity,positive predictive value and negtive value and draw ROC curve,calculate Yodex index,calrify the ideal cut-off.Compare and evaluate diagnostic performance of CA125,HE4,ROMA,RMI and CPH-I in differentiating benign and malignant ovarian tumor.ResultsWhen comparing bengin tumor group with non benign tumors group(BOT+malignant),in general population,the sequence of AUC values of biomarkers and risk models are:CPH-IROMA>HE4>CA125>RMI,senstivity and specificity:CA125>ROMA>CPH-I>HE4>RMI,CPH-I>HE4>RMI>ROMA>CA1 25?When comparing benign tumor group with meligant tumors group,in general population,the sequence of AUC values:CPH-I>HE4>ROMA>CA125>RMI,sensitivity and specificity:CA125>ROMA=HE4>CPH-I>RMI,CPH-I>HE4=RMI>ROMA>CA125.When diffretiating benign tumors and epithelial tumors,the sequence of AUC values in general population are CPH-I>ROMA>HE4>CA125>RMI,sensitivity and specificity are CA125>CPH-I>ROMA>HE4>RMI,CPH-I>HE4=RMI>ROMA>C A125.Based on the data of this study,the ideal cut-offs are 45.5U/mL(CA125),50.1 pm/L(HE4),8.44%(CPH-I),7.76(ROMA),61.35(RMI)?Conclusion1.According to Meta analysis of previous studies,ROMA has closed diagnostic values compred to RMI(AUC:0.899,0.906),and better than HE4 and ca125(AUC:0.889,0.867);ROMA has best sensitivity(86%)and RMI has best specificity(84%),and HE4 is closed to RMI(83%).2.Copenhagen Index(CPH-I)can be used in differentiating benign and malignant ovarian tumors.3.In general population,CPH-I has closed diagnostic values compared to ROMA when differentiating benign tumors from non-benign tumors(BOT+malignant),malignant tumors and epithelial melignnat tumor.CPH-I prerform slightly better than ROMA in general population,premenopausal population,while in postmenopausal population,ROMA is slightly better than CPH-I.When diagnosing tumor in early stage,ROMA work better than CPH-I in assessing epithelial malignant tumor,however,when diagnosing non-benign tumors and malignant tumors in early stage,CPH-I perform better. |
PDF Full Text Request