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

Table 9

Diagnostic odds ratio (DOR) and area under the curve (AUC) for the predictive accuracy of classical and modified risk of malignancy indices (RMIs) 1–4 for the differentiation of malignant stage I (FIGO) from nonmalignant adnexal tumors.

RMI variant	DOR; (95% CI)	AUC; (95% CI)	value	Optimal cut-off
RMI 1	6.8; (1.9–24.5)	0.686; (0.535–0.837)	0.013	12.5
RMI 2	4.2; (1.4–12.5)	0.692; (0.541–0.843)	0.010	58
RMI 3	5.1; (1.6–16.2)	0.674; (0.519–0.830)	0.019	53
RMI 4	3.9; (1.1–13.4)	0.717; (0.570–0.864)	0.004	83
mRMI 1	4.2; (1.4–12.5)	0.715; (0.561–0.869)	0.004	38
mRMI 2	9.1; (2.8–29.4)	0.802; (0.690–0.913)	<0.001	177
mRMI 3	6.6; (2.2–19.7)	0.803; (0.692–0.914)	<0.001	135
mRMI 4	7.2; (2.2–23.2)	0.801; (0.682–0.920)	<0.001	205

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). FIGO: Fédération Internationale de Gynécologie et d’Obstétrique.