Introduction/Background Ovarian cancer has a low incidence (10/100,000), but a high mortality rate explained by the fact that 75% of cases are diagnosed late due to non-specific clinical signs. To help with early diagnosis of ovarian cancer, new markers and scores were evaluated, such as HE4 and the ROMA score. The objective of our work is to evaluate the diagnostic value of HE4 and the ROMA score in order to make management recommendations and improve prognosis.

Methodology Review of literature in French and English from 2009 to 2023 on the Pubmed, Cochrane and Embase databases.

Results Dosage CA125 is recommended for the diagnosis of ovarian masses suspected of malignancy on imaging. HE4 dosage is recommended for the diagnosis of an indeterminate ovarian mass on imaging.

Comparison of data on the sensitivity and specificity of serum CA125 and HE4 shows that CA125 has low specificity and sensitivity for first-line diagnosis, as its expression is notably absent in early stages (I and II) and in non-mucinous ovarian malignancies (serous, endometroid and clear cell cancers). HE4, on the other hand, is more sensitive and specific because it is expressed in all types of ovarian cancer, in the early stages and because it detects recurrence more quickly, given that its concentration increases 2 to 5 months before a clinical recurrence, making it an interesting marker for therapeutic follow-up and also for the differential diagnosis of endometriosis.

The ROMA score evaluates the risk of malignancy by combining serum measurements of HE4, CA125 and menopausal status. It has an excellent and consistent negative predictive value (NPV) of 98 to 100%, giving a high assurance that a pelvic mass is benign if the ROMA score indicates a low risk.

Conclusion Early diagnosis and detection of recurrence is the only way to improve prognosis in the short term.

Disclosures The authors have no conflicts of interest to declare. There was no funding for this study.