{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T21:44:00Z","timestamp":1755035040065,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100016545","name":"Roche Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>CA\u00a0125, the biomarker in common clinical use for ovarian cancer, is limited by low sensitivity for early disease and high false positives. The aim of this study was to evaluate several candidate biomarkers, alone or in combination, compared with CA\u00a0125 in the prediction of malignant\/borderline vs benign tumor status in premenopausal and postmenopausal women with pelvic masses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This was a retrospective observational cohort study set in St James\u2019s Hospital, a tertiary referral center for gynecological malignancy in Dublin, Ireland. Women undergoing surgery for pelvic masses between 2012 and 2018 were included. Preoperative human epididymis protein 4 (HE4), the Risk of Ovarian Malignancy Algorithm, the Risk of Malignancy Index I and II, D\u2010dimer, and fibrinogen were assessed. Logistic regression models were fitted for each biomarker alone and in combination. Receiver operating characteristics\u2010area under the curve (ROC\u2010AUC) and partial AUCs in the 90%\u2010100% specificity range were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 89 premenopausal and 185 postmenopausal women were included. In premenopausal women, no biomarker(s) outperformed CA\u00a0125 (AUC 0.73; 95% CI 0.63\u20130.84). In postmenopausal women, HE4 had a partial AUC (pAUC) of 0.71 (95% CI 0.64\u20130.79) compared with 0.57 (95% CI 0.51\u20130.69) for CA\u00a0125 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.009). HE4 + D\u2010dimer had an improved pAUC of 0.74 (95% CI 0.68\u20130.81, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and HE4 + D\u2010dimer + fibrinogen had a pAUC of 0.75 (95% CI 0.68\u20130.82).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A novel biomarker panel of HE4\u00a0\u00b1\u00a0D\u2010dimer\u00a0\u00b1\u00a0fibrinogen outperformed CA\u00a0125 alone as a high\u2010specificity biomarker in postmenopausal women and could aid in the preoperative triaging of pelvic masses. No biomarker(s) outperformed CA\u00a0125 in premenopausal women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14126","type":"journal-article","created":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T13:36:14Z","timestamp":1613482574000},"page":"1239-1247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The value of human epididymis 4, <scp>D<\/scp>\u2010dimer, and fibrinogen compared with CA\u00a0125 alone in triaging women presenting with pelvic masses: a retrospective cohort study"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4474-0273","authenticated-orcid":false,"given":"Kate","family":"McKendry","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Trinity Centre for Health Sciences St James\u2019s Hospital Dublin Ireland"},{"name":"Trinity St James\u2019s Cancer Institute St James's Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Duff","sequence":"additional","affiliation":[{"name":"UCD Clinical Research Centre UCD School of Medicine St Vincent\u2019s University Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanmei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Trinity Centre for Health Sciences St James\u2019s Hospital Dublin Ireland"},{"name":"Trinity St James\u2019s Cancer Institute St James's Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa","family":"Redha","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Clinical Pathology Laboratory St James's Hospital James's Street Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ine","family":"Scanlon","sequence":"additional","affiliation":[{"name":"Department of Biochemistry Clinical Pathology Laboratory St James's Hospital James's Street Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feras","family":"Abu Saadeh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Trinity Centre for Health Sciences St James\u2019s Hospital Dublin Ireland"},{"name":"Trinity St James\u2019s Cancer Institute St James's Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noreen","family":"Gleeson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Trinity Centre for Health Sciences St James\u2019s Hospital Dublin Ireland"},{"name":"Trinity St James\u2019s Cancer Institute St James's Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"O\u2019Leary","sequence":"additional","affiliation":[{"name":"Trinity St James\u2019s Cancer Institute St James's Hospital Dublin Ireland"},{"name":"Department of Histopathology Trinity College Dublin, and Emer Casey Molecular Pathology Research Laboratory Coombe Women\u2019s and Infants University Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Norris","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Trinity Centre for Health Sciences St James\u2019s Hospital Dublin Ireland"},{"name":"Trinity St James\u2019s Cancer Institute St James's Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9260-3225","authenticated-orcid":false,"given":"Sharon","family":"O\u2019Toole","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Trinity Centre for Health Sciences St James\u2019s Hospital Dublin Ireland"},{"name":"Trinity St James\u2019s Cancer Institute St James's Hospital Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"National Cancer Institute NIoH.Cancer stat facts: ovarian cancer 2018. 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