Research Article

Can Replacing CA125 with HE4 in Risk of Malignancy Indices 1–4 Improve Diagnostic Performance in the Presurgical Assessment of Adnexal Tumors?

Table 11

Diagnostic performance of modified risk of malignancy indices (mRMIs) 1–4 for the differentiation of malignant stage I (FIGO) from nonmalignant adnexal tumors.

RMI variant Diagnostic performance of mRMI
Sensitivity
(95% CI)
Specificity
(95% CI)
PPV
(95% CI)
NPV
(95% CI)
LR+
(95% CI)
LR−
(95% CI)
Diagnostic accuracy
(95% CI)

mRMI 168.7%
(46–91.4%)
65.7%
(60–71.5%)
11%
(4.8–17.1%)
97.1%
(94.7–99.6%)
2
(1.3–2.9)
0.4
(0.2–0.9)
65.9%
(60.3–71.5%)
mRMI 275%
(53.7–96.2%)
75.3%
(70.1–80.6%)
15.7%
(7.5–23.9%)
98%
(96–99.9%)
3
(2.1–4.3)
0.3
(0.1–0.7)
75.3%
(70.2–80.4%)
mRMI 368.7%
(46–91.4%)
75%
(69.7–80.2%)
14.4%
(6.5–22.3%)
97.5%
(95.3–99.6%)
2.7
(1.8–4)
0.4
(0.2–0.8)
74.6%
(69.5–79.7%)
mRMI 475%
(53.7–96.2%)
70.7%
(65.2–76.2%)
13.6%
(6.4–20.8%)
97.8%
(95.8–99.9%)
2.5
(1.8–3.6)
0.3
(0.1–0.8)
71%
(65.6–76.3%)

Modified RMIs (mRMIs) were obtained by replacing cancer antigen 125 with human epididymis secretory protein 4 in the classical RMI. Data are shown with 95% confidence intervals (CIs). PPV: positive predictive value; NPV: negative predictive value; LR+: positive likelihood ratio; LR−: negative likelihood ratio; FIGO: Fédération Internationale de Gynécologie et d’Obstétrique.