ROMA Test - Book at Affordable Cost

Ovarian cancer is the most common malignancy associated with the female reproductive system. The tumour markers are used for early diagnosis, as early diagnosis is key for improving survival rate of cancer patients. carbohydrate antigen-125 and the human epididymis protein 4 are biomarkers which are used for diagnosis.

• Benign tumour- it is localised in nature with well defined borders.
• Malignant tumour- the tumour which has a tendency to show metastasis.

The Risk of Ovarian Malignancy Algorithm (ROMA) is a logistic regression algorithm that incorporates cancer antigen 125 , human epididymal protein 4 and menopausal status to assess the risk that an ovarian cyst or pelvic mass is benign or malignant.

Roma is used to assess whether premenopausal or postmenopausal women having an ovarian adrenal mass are at low or high risk of developing malignancy. The risk is assessed based on combined numerical score of HE4, CA125, and menopausal status.

CA 125 Tumour marker

It is a protein that is found in greater concentration in tumour cells than normal body cells. CA 125 is mostly found in greater concentration in ovarian cancer cells, so it plays role in diagnosis of ovarian cancer.

HE 4 Tumour marker

HE 4 is a tumour marker but it has greater efficacy than CA 125. It has more sensitivity and specificity so it is better than CA 125 detection.It helps in diagnosis of ovarian cancer at early stage.

Criteria for ROMA

Women age must be above 18

Ovarian adnexal mass present.

Calculation of ROMA is done as

For premenopausal- 12+2.38 × LN(HE4)+0.062 6 × LN(CA-125)

For postmenopausal- 8.09+1.04 × LN(HE4)+0.732 × LN(CA-125)

Reference value for ROMA are

HEP 4≤140 pmol/L

CA 125 <46 U/mL

ROMA SCORE

Premenopausal: <1.14 (low risk)

Postmenopausal: <2.99 (low risk)

Interpretation

In premenopausal women ROMA score 1.14 or more than 1.14 shows high risk whereas in postmenopausal women ROMA score of 2.99 or more than 2.99 shows high risk of finding epithelial ovarian cancer at  surgery.

Cautions

It should not be used independently

It is not used determine whether patient should proceed surgery.

Roma is not valid for

• Women with treated malignancy previously
• Women under the age of 18
• Pregnant women
• Women going under chemotherapy