Diagnosis of ovarian cancer using multiple biomarkers of CA 125, CA153, CA 19-9, CEA, HE4 and ROMA index

To investigate the value of tumor biomarkers of CA125, CA153, CA 19-9, CEA, human epididymis protein 4 (HE4) and ROMA index in combination for the diagnosis of epithelial ovarian tumors. Patients with epithelial ovarian tumors were retrospectively enrolled in comparison with healthy controls. The venous blood samples were tested and analyzed. The CA 19-9 value was significantly (P < 0.05) greater in borderline tumors than in ovarian cancers, benign tumors or healthy controls, and significantly (P < 0.05) greater in benign tumors than in healthy controls. Compared with the borderline tumors, the ovarian cancer in stages III and IV had significantly (P < 0.05) greater CA 125, CA 153, HE 4, ROMA 1 and ROMA 2 but significantly (P < 0.05) smaller CA 19-9. Stage-II ovarian cancer also had significantly (p < 0.05) greater CA 153 but smaller CA 19-9 than borderline tumors. The CA 19-9 value was significantly greater in the epithelial mucous cancer (50.15) or the borderline non-mucinous (22.90) or mucinous (47.55) tumor than in the non-mucinous cancer (12.15), benign tumors (14.80), or healthy controls (9.40). CA 125, CA 19-9, HE 4, ROMA 1, ROMA 2 and CA 153 had larger AUC and Youden indexes for diagnosing borderline tumors, and CA 125, CA 153, HE 4, ROMA 1 and ROMA 2 had larger AUC and Youden indexes for diagnosing ovarian cancers. For epithelial borderline tumors, CA 125, HE 4, ROMA 1, and ROMA 2 may have higher diagnostic value, especially ROMA 2 and CA 125. For ovarian cancer, ROMA 2, CA125, ROMA 1, HE4, and CA153 may have the highest clinical application value. CA 19-9 elevation may indicate mucinous ovarian cancer or mucinous borderline tumor. Elevated CA153 also has certain application value.