ReviewCureus2025
Comparative Meta-Analysis of Carbohydrate Antigen 125 (CA125), Human Epididymis Protein 4 (HE4), and Diagnostic Indices (Risk of Malignancy Index (RMI) and Risk of Ovarian Malignancy Algorithm (ROMA)) for Pre-operative Detection of Ovarian Carcinoma.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Translational Perspectives on Cell-Free Mitochondrial DNA as a Biomarker in Gynecological Cancers: Current Limitations and Future Research Directions.Biomolecules · 2026Review
- Integration of serological markers with O-RADS ultrasound risk stratification achieves high diagnostic accuracy for early ovarian cancer: development and validation of an interpretable model.American journal of cancer research · 2026Article
- Clinical value of serum biomarkers, magnetic resonance imaging risk scoring, and malignancy risk indices in distinguishing benign and malignant ovarian masses: an observational study.Cancer causes & control : CCC · 2025Observational
- Minimal Residual Disease Detection: Bridging Molecular and Clinical Strategies for Recurrence Prevention in Gynecologic Cancers.International journal of molecular sciences · 2025Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ovarian cancer remains a leading cause of gynecological cancer-related mortality, primarily due to late-stage diagnosis. Effective pre-operative differentiation between benign and malignant ovarian masses is crucial for improving patient outcomes. This meta-analysis evaluates the diagnostic performance of carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4), the Risk of Malignancy Index (RMI), and the Risk of Ovarian Malignancy Algorithm (ROMA) by assessing their sensitivity, specificity, and overall accuracy. A systematic review of studies published between 2000 and 2024 identified 12 eligible studies with sample sizes ranging from 84 to 456 participants. Statistical analyses, including bivariate modeling and summary receiver operating characteristic curves, were performed. CA125 demonstrated the highest sensitivity (0.82) but had a high false-positive rate (0.357), limiting its specificity. HE4 exhibited higher specificity (0.171) and an improved diagnostic odds ratio (DOR = 17.00) compared to CA125. The ROMA and RMI showed comparable performance, with the ROMA achieving the highest area under the curve (AUC = 0.8619), followed by HE4 (AUC = 0.8586) and RMI (AUC = 0.8508), while CA125 had the lowest AUC (0.8128), indicating lower standalone diagnostic reliability. The findings suggest that HE4, ROMA, and RMI outperform CA125 in terms of specificity and overall diagnostic accuracy, with HE4 and ROMA particularly demonstrating superior specificity. These results support a multimodal diagnostic approach that integrates multiple biomarkers and risk indices to enhance pre-operative ovarian cancer detection and optimize patient management.
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Registered trials
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