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273 Performance of CA125, HE4, ROMA and ultrasound sassone score in discriminating early and late stages of epithelial ovarian cancer
  1. Mario Puljiz1,
  2. Luka Marcelic1,
  3. Damir Danolic1,
  4. Lucija šušnjar1,
  5. Ilija Alvir1,
  6. Marija Banovic2,
  7. Ivica Mamic1,
  8. Zvjezdana Špacir Prskalo3 and
  9. Ljiljana Mayer3
  1. 1Department of Gynaecologic Oncology, University Hospital for Tumours, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia
  2. 2Polyclinic Leptir, Zagreb, Croatia
  3. 3Department of Medical Biochemistry in Oncology, University Hospital for Tumours, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia


Introduction/Background Epithelial ovarian cancer (EOC) remains one of the leading cause of cancer-related death in women worldwide. Due to our inability to detect early-stage disease, the overall survival of patients with EOC remains poor, ranging from 30–50 % at 5 years after diagnosis. The aim of this study was to compare diagnostic performance of tumour markers CA125, HE4, ROMA and ultrasound Sassone score (US) in patients with EOC.

Methodology In this retrospective study 59 women with histologically confirmed EOC were included. The diagnostic performances of CA 125, HE4, ROMA score and ultrasound Sassone score obtained prior to surgery were analyzed.

Results The patients with EOC were diagnosed most often in advanced stages. Among the 59 patients with EOC, 18 (30.5%) were stage I-II, 41 were stage III-IV (69.5%). In differentiation between early (FIGO I-II) and advanced stages (FIGO III-IV) ROMA, HE4, CA125 had high area under the curve (AUC) (0.949, 0.941 and 0.913, respectively), while US showed the lowest AUC (0.805). There was statistically significant difference between the AUC values of tumour markers and US in detection of EOC stage (HE4 vs US, p = 0.004, CA125 vs US, p = 0.023, ROMA vs US, p = 0.005). CA125 was elevated in 40% of patients (7/18) in stage I-II disease, 94% (30/32) in stage III and 100% (9/9) in stage IV. HE4 and ROMA revealed better results in early stages (elevated in 72,2% and 66,7%), while results in advanced stages were similar (>95%).

Conclusion CA125, HE4 and ROMA performed significantly better in discriminating early and late stages of disease when compared to ultrasound Sassone scoring system. Although HE4 and ROMA performed better than CA125, none of them seems to be reliable tool in diagnosis of early-stage EOC.

Disclosures The authors report no conflict of interest.

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