CLINICAL UTILITY OF CA125, HE4 AND RISK OF OVARIAN MALIGNANCY ALGORITHM (ROMA) FOR EARLY DETECTION OF OVARIAN CARCINOMA

Abstract

Ovarian cancer is the leading cause of mortality from gynaecological cancer in worldwide. Majority of patients with advanced disease face relapse
following primary treatment. Early diagnosis of ovarian cancer is difficult due to its asymptomatic nature and the lack of sensitive screening
methods. So, the challenge still exists to develop appropriate serum markers for the screening and detection in early stages of cancer progression.
Patient in advanced phase undergo continuous biomarker monitoring and follow-up for proper treatment. In past decades, numbers of potential serum
biomarkers have been assessed in diagnosing of ovarian cancer. These includes structural as well as functional component of the cell and tissue such
as various Cytokines, biological factors (coagulation, growth and apoptosis factors), hormones and adhesion molecules, but none of them have been
applied to everyday clinical practice. Nowadays, serum cancer antigen 125 (also called as carbohydrate antigen 125 or CA125) and human
epididymis 4 protein (HE4) are clinically approved biomarkers with reliable sensitivity and specificity of diagnosis. Next step in the diagnosis is the
utilization of Risk of Ovarian Malignancy Algorithm (ROMA) which incorporates the results of HE4 and CA125 levels and menopausal status
becoming more and more widespread in clinical practice for the evaluation of ovarian cancer. This review will focus on the utility of the combination
of CA125 and HE4 as ROMA and the comparison of ROMA with alone CA125, HE4 and RMI with the future directions in ovarian cancer
screening