MRI combined with CA125,HE4 and ROMA index in predicting efficacy of tumor reductive surgery for ovarian cancer pa-tients with peritoneal metastasis
Objective To investigate the value of MRI peritoneal cancer index(MRI-PCI),carbohydrate antigen 125(CA125),human epididymis protein 4(HE4),and Roman index(ROMA index)in predicting efficacy of tumor reductive surgery for patients with ovarian cancer peritone is metastasis.Methods Sixty patients with advanced ovarian cancer admitted in Yichang Second People's Hospital from February 2018 to October 2022 were enrolled.All patients completed MRI plain scan,contrast-enhanced scan,and DWI imaging within 2 weeks prior to surgery,and MRI-PCI score was calculated.Serum CA125 and HE4 levels were measured within one week before surgery.All patients underwent tumor reduction surgery and were divided into complete reduction group and incomplete reduction group.Pearson correlation analysis was used to examine the correlation between preoperative MRI-PCI and intraoperative PCI.ROC curve was used to analyze the value of MRI-PCI,CA125,HE4,and ROMA index in predicting surgical efficacy.Results Spearman correlation coefficient between preoperative MRI-PCI and intraoperative PCI was 0.898.In predicting incomplete reduction surgery,the AUC of MRI-PCI,CA125,HE4,and ROMA curves were 0.913,0.731,0.611 and 0.716 respectively.The optimal cut-off value of MRI-PCI was 4.5,and the sensitivity,specificity,positive predictive value and negative predictive value for predicting incomplete reductive surgery were 0.920,0.898,0.781 and 0.822,respectively.The optimal cut-off values of CA125,HE4 and ROMA index were 880.26 U/mL,488.98 pmol/L and 96.53%,respectively;the corresponding sensitivity was 0.782,0.760 and 0.688;the specificity was 0.655,0.780 and 0.898;the positive predictive value was 0.711,0.611 and 0.647;the negative predictive value was 0.733,0.717 and 0.802,respectively.Conclusion MRI-PCI is significantly correlated with intraoperative PCI,and it has the best predictive value for incomplete reduction surgery when MRI-PCI is 4.5.
Ovarian cancerPeritoneal cancer indexTumor excisionDiffusion imaging