The Diagnostic Value Of ROMA Index In Benign And Malignant

Objective By analyzing the factors affecting the ROMA index of patients with ovarian tumors,the critical value of the probability of optimal prediction of ovarian malignant tumors by ROMA index was calculated,and the clinical diagnostic value of ROMA index in patients with benign and malignant ovarian tumors and epithelial ovarian cancer were investigated.Clinical diagnostic value.MethodsA total of 511 patients who underwent pelvic mass admission from the General Hospital of Ningxia Medical University from January 2015 to April 2018,who were surgically treated and diagnosed with ovarian tumors were collected.According to the histological classification of the World Health Organization’s ovarian tumors in 2003,the included cases were classified into 324 cases of ovarian malignant tumors,93 cases before menopause,and 231 cases after menopause.There were 187 patients with benign ovarian tumors,and 143 patients and 44 postmenopausal patients.Using the Roche Cobas e602electrochemiluminescence immunoassay analyzer,the serum of patients with ovarian tumors was detected according to the actual situation,and the levels of HE4 and CA125 were determined.The ROMA index was calculated by combining the menopausal status,and the ROMA was calculated by plotting the ROC curves before and after menopause.The optimal index predicts the critical value of the probability of ovarian malignancy and assesses the risk of ovarian malignancy in patients.Results 1.The test results showed that the ROMA index,HE4,and CA125 x±s of patients with ovarian benign tumors and ovarian malignant tumors were 8.79±6.22 and67.40±35.56,50.35±15.82 and 462.42±466.63,23.98±32.33 and 985.45±1336.50,it can be seen that the malignant tumor group was significantly higher than the benign tumor group(t_ca125=-12.94,t_He4=-28.91,t_ROMA=-15.88,P<0.001).2.The analysis data show that for patients with ovarian malignant tumors,its ROMA index,HE4,CA125 will be affected by many factors,such as pathological stage,age,menopausal status,etc.in age≥50,postmenopausal and surgery The positive expression rate of CA125 and HE4 and the ROMA index were the highest in stage III-IV of pathological stage.The difference of ROMA index between each group was t_age≥50=7.28,t _{postmenopausal}=-5.99,t _III-IV=-13.25,P<0.001,the positive expression rate of HE4 was X2 _age≥50=29.16,X²_{postmenopausal}=20.42,X²_III-IV=118.37,P<0.001,and the positive expression rate of CA125 was X² _age≥50=7.74,.X²_{postmenopausal}=3.26,X²_III-IV=87.04,no significant difference before and after menopause P=0.71,other differences were statistically significant P<0.001.3.Through the ovarian malignant tumors before and after menopause,different serum CA125,HE4 levels and ROMA index to draw the ROC curve of ovarian malignant tumor before and after menopause to obtain AUC,0.885,0.902,0.914 before menopause,0.955,0.942 after menopause,respectively.The AUC of0.962,CA125 and HE4 is lower than the ROMA index.It can be seen that the accuracy of determining whether a patient has an ovarian malignant tumor by CA125 or HE4 is lower than that of the ROMA index,that is to say,the result of the ROMA index is more accurate.The optimal predictive probability threshold for the ROMA index was determined by the ROC curve of the ROMA index before and after menopause to be 9.32%before menopause and 24.11%after menopause.The definition is greater than or equal to the threshold value of the high-risk group,and the lower-threshold value is the low-risk group.Fisher’s exact probability test shows that the premenopausal ROMA index predicts the serous cystadenocarcinoma and mucinous sac of different pathological types of epithelial ovarian cancer.The probability of adenocarcinoma,clear cell carcinoma and endometrioid carcinoma as ovarian cancer patients is 92.30%,57.14%,56.25%,100%compared with serous ovarian cancer,except for endometrioid ovarian adenocarcinoma.P<0.05,the difference was not statistically significant,and the other pathological types showed a statistically significant difference（P<0.05）.After menopause,when the different pathological types of epithelial ovarian cancer are analyzed and judged by ROMA index,the pathological types are different,then the diagnostic accuracy is also different,and the probability of predicting endometrioid adenocarcinoma is 57.14%.The probability of serous cystadenocarcinoma was 99.45%,the probability of clear cell carcinoma was 88.895%,and the probability of mucinous cystadenocarcinoma was 77.78%.5.Before menopause,the ROMA index was used to accurately predict the epithelial ovarian cancer as FIGOI/II,and the III/IV probabilities were57.14%and 36.84%,respectively.The postmenopausal ROMA index predicts epithelial ovarian cancer as FIGOI/II,III/The probability of stage IV was 91.84%and 94.67%,respectively,and the difference was statistically significant（P<0.05）.Conclusion1.CA125 has the lowest diagnostic value for the auxiliary diagnosis of benign and malignant ovarian tumors.2.To calculate and analyze the pre-menopausal and postmenopausal ROMA index,and to predict and judge the optimal threshold of ovarian malignant tumor probability,which can effectively improve the accuracy of ROMA index for ovarian malignant tumor risk assessment.3.Among the different pathological types of ovarian malignant tumors and patients with different surgical pathological stages,the ROMA index has the greatest clinical value in the diagnosis of patients with epithelial ovarian malignant tumors.