HE4 with ROMA Index Test
HE4 with ROMA Index Test
When diagnosed at early-stage (Stage I), ovarian cancer responds well to conventional surgery and chemotherapy for up to 90% of patients. Yet, many women succumb to ovarian cancer each year due to the lack of specific symptoms.
Employing tumor markers as screening tools aid clinicians in diagnosing ovarian cancer in its earliest stages, which not only allows more treatment options but also helps them anticipate treatment responses more effectively.
HE4 (Human Epididymis Protein-4) is a protein by epithelial cells that exhibits increased expression in most ovarian cancers. It serves as a biomarker for recurrence or disease progression in follow-up cancer patients.
It is also used in conjunction with CA-125(another biomarker), which is a part of the ROMA (Risk of Ovarian Malignancy Algorithm) calculation.
ROMA is an algorithm that incorporates HE4 and CA-125 measurements with a woman's menopausal status to compute an index. It is used to assess the risk of ovarian cancer in premenopausal and postmenopausal women with pelvic tumors.
What is the HE4-ROMA Test Used For?
The HE4-ROMA test is mainly used
To assess the risk of ovarian cancer in women who are present with adnexal mass.
To distinguish low risk (benign) from high risk ovarian cancer(malignant)
To differentiate ovarian cancer from endometriotic cyst and other ovarian masses
To monitor the treatment efficiacy and know whether epithelial ovarian cancer has come back.
Symptoms of Ovarian cancer
Renowned as the "silent killer," ovarian cancer usually lacks symptoms in the early stages. And if present, they are vague and may include
Pelvic pain or discomfort
Unusual bloating of belly
Loss of appetite
Unexplained weight loss and gain
A frequent need to urinate
Pain during sexual intercourse
Extreme fatigue
Preparation for Test
This test doesn't require specific preparation. You can follow your normal routine or eat as usual before sampling.
Interpretation of Test Results
In the ROMA index, ovarian malignancies are classified into high- and low-risk categories according to the woman's age and menopausal status.
In postmenopausal women:
ROMA score - 1.14 or greater (High risk )
ROMA score – less than 1.14 (Low risk)
In postmenopausal women:
ROMA score – 2.99 or greater (High risk )
ROMA score – less than 2.99 (Low risk)
Caution: These results are not definitive and must be supported with clinical and radiological findings
FAQs
What is the significance of HE4 estimation compared to CA-125 in diagnosing ovarian cancer?
Even though HE4 and CA-125 are used as tumor markers for ovarian cancer, HE-4 is more sensitive in detecting the early stages of the disease when compared to CA-125. Combined with the ROMA index, HE-4 gives a more accurate risk prediction for ovarian cancer.
Are there any limitations to this test?
The HE4 with ROMA Index test is not conclusive, and its findings must be combined with clinical evaluation to confirm the diagnosis.
How should I proceed if my ROMA Index is high?
If your ROMA Index is high, consult an oncologist right away to determine the risk or presence of ovarian cancer.
What factors can affect the test results?
Factors such as certain medications, underlying medical conditions, and recent surgeries can interfere with the measurements of HE4 and CA-125 in the blood.
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