{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:03:23Z","timestamp":1789653803912,"version":"4.0.0"},"reference-count":19,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to compare the diagnostic accuracy of four serum biomarkers\u2014carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4), the Risk of Ovarian Malignancy Algorithm (ROMA), and the Copenhagen Index (CPH\u2010I)\u2014for the preoperative discrimination of benign\/borderline from malignant ovarian cancer, with particular attention to menopausal status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study enrolled 345 patients with histologically confirmed ovarian tumors (187 benign\/borderline; 158 malignant). Serum CA125 and HE4 were measured and reported by the electrochemiluminescence immunoassays, along with the calculated indices of ROMA and CPH\u2010I. Diagnostic performance was assessed by the area under the curve (AUC), sensitivity, and specificity, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 158 ovarian tumors patients, CPH\u2010I demonstrated superior discriminative capacity with the highest AUC (0.924), followed by ROMA (0.916), HE4 (0.897), and CA125 (0.865). Menopausal stratification identified CPH\u2010I as optimal for premenopausal women (AUC 0.886) and ROMA for postmenopausal women (AUC 0.928). ROMA exhibited the highest overall sensitivity (84.8%), whereas CA125 achieved the highest overall specificity (94.1%). In premenopausal patients, HE4 demonstrated exceptional specificity (98.6%), while postmenopausal women showed equivalent specificity between HE4 and CPH\u2010I (both 97.8%). In combined panels, CA125\u2009+\u2009HE4\u2009+\u2009CPH\u2010I yielded the highest overall accuracy (AUC 0.925), and CA125\u2009+\u2009HE4\u2009+\u2009ROMA provided optimal postmenopausal performance (AUC 0.930).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CPH\u2010I demonstrated favorable diagnostic performance compared with conventional biomarkers. Our findings advocate for a menopausal status\u2010guided clinical algorithm, utilizing a CPH\u2010I\u2010based panel for premenopausal women and a ROMA\u2010based panel for postmenopausal women to maximize diagnostic precision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcla.70319","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T09:02:56Z","timestamp":1786438976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of Serum\n                    <scp>CA125<\/scp>\n                    ,\n                    <scp>HE4<\/scp>\n                    ,\n                    <scp>ROMA<\/scp>\n                    , and\n                    <scp>CPH<\/scp>\n                    \u2010I in the Preoperative Differentiation of Ovarian Tumors: A Diagnostic Accuracy Study"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8946-4248","authenticated-orcid":false,"given":"Weiming","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital Capital Medical University, Beijing Maternal and Child Health Care Hospital  Beijing China"},{"name":"Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital Capital Medical University. Beijing Maternal and Child Health Care Hospital  Beijing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital Capital Medical University, Beijing Maternal and Child Health Care Hospital  Beijing China"},{"name":"Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital Capital Medical University. Beijing Maternal and Child Health Care Hospital  Beijing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingxin","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital Capital Medical University, Beijing Maternal and Child Health Care Hospital  Beijing China"},{"name":"Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital Capital Medical University. Beijing Maternal and Child Health Care Hospital  Beijing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital Capital Medical University, Beijing Maternal and Child Health Care Hospital  Beijing China"},{"name":"Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital Capital Medical University. Beijing Maternal and Child Health Care Hospital  Beijing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyun","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Beijing Obstetrics and Gynecology Hospital Capital Medical University. Beijing Maternal and Child Health Care Hospital  Beijing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7575-7396","authenticated-orcid":false,"given":"Yanhong","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital Capital Medical University, Beijing Maternal and Child Health Care Hospital  Beijing China"},{"name":"Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital Capital Medical University. Beijing Maternal and Child Health Care Hospital  Beijing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0968-1864","authenticated-orcid":false,"given":"Zheng","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Beijing Obstetrics and Gynecology Hospital Capital Medical University, Beijing Maternal and Child Health Care Hospital  Beijing China"},{"name":"Center of Clinical Mass Spectrometry, Beijing Obstetrics and Gynecology Hospital Capital Medical University. 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