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It is our pleasure to inform you that we have introduced ROMA (RISK OF OVARIAN MALIGNANCY ALGORITHM) in our Lab Medicine Department. ROMA is a qualitative serum test that combines the results of HE4 (HUMAN EPIDIDYMIS PROEIN 4) CA 125 and menopausal status into a numerical score.

ROMA is intended to aid in assessing whether a premenopausal or postmenopausal woman who presents with an ovarian adnexal mass is at high or low likelihood of finding malignancy on surgery. ROMA is indicated for women who meet the following criteria: A) Age over 18, B) Ovarian adnexal mass present for which surgery is planned, and C) Not yet referred to an oncologist. ROMA must be interpreted in conjunction with an independent clinical and radiological assessment. The test is not intended as a screening or stand-alone diagnostic assay.

CA125 is, to date, the best known test for ovarian cancer diagnosis. However, only about 85% of all women with ovarian cancer have raised CA 125, only 50% of women with early stage ovarian cancer have raised CA 125, approximately 20% of ovarian cancers lack expression of CA125, and women with other, or benign, conditions can also have raised CA125 levels.

HE4 is a new marker for ovarian carcinoma, which is over-expressed in patients with ovarian, and some other cancers. Normal ovarian tissue has minimal production of HE4. When combined with CA125, HE4 significantly raises the level of sensitivity for the detection of ovarian cancer. HE4 is consistently expressed in patients with ovarian cancer and has demonstrated an increased sensitivity and specificity over that of CA125 alone. In clinical study at a set specificity of 75% the sensitivity for epithelial ovarian cancer of the assay was 94% for all patients with a 98% Negative Predictive Value (NPV) for pre and post-menopausal women.

How to Read the Test

The following cut-points were used to reach our set level of specificity when using the HE4 assay and CA125 assay for ROMA SCORE

  • Premenopausal:
    • ROMA Value ≥ 7.4 High likelihood of finding epithelial ovarian cancer
    • ROMA Value < 7.4 Low likelihood of finding epithelial ovarian cancer
  • Postmenopausal:
    • ROMA Value ≥ 25.3 High likelihood of finding epithelial ovarian cancer
    • ROMA Value < 25.3 Low likelihood of finding epithelial ovarian cancer

Matrix; Serum (Red top)

Volume: 4 ml
Tariff: BDT 3,500.00
Turn Around Time: Next day Evening (5:00 PM)
Test Code :11042

PRECAUTION: ROMA (HE4 + CA125) should not be used without an independent clinical/radiological evaluation and is not intended to be a screening test. Incorrect use of ROMA carries the risk of unnecessary testing, surgery, and/or delayed diagnosis.

For any Query
Dr. Mohammad Ibrahim
MBBS, M.D
Consultant Clinical Biochemistry
Lab Medicine Department
Apollo Hospitals Dhaka
Mobile: 01713047967

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