الفهرس 
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Abstract
• The aim of the present study is to evaluate the role of HE4 level and ROMA score in detection of ovarian malignancy in women attending Zagazig University Hospitals.
• The study included 56 premenopausal women with ovarian mass, 56 postmenopausal women with ovarian mass and 56 women as healthy control. The mean age for premenopausal, postmenopausal and control were 34.41, 59.76 and 45.36 years respectively.
• They were studied for HE4 tumor marker by ELISA technique. Serum level of CA125 was estimated for each woman. ROMA was calculated.
• Malignant ovarian masses were more frequent among postmenopausal patients compared to premenopausal patients.
• There was no statistically significant difference of median serum CA125 in different stages of ovarian cancer (p = 0.5), while there were statistically significant differences of median serum HE4 and ROMA (p = 0.002).
• The median serum CA125, HE4 and ROMA concentration were significantly higher among postmenopausal group compared with premenopausal and control groups. They were also statistically higher among malignant lesions compared with benign lesions and control group.
• Combining CA125 and HE4 in ROMA showed better performance than CA125 alone in premenopausal group.
• According to a cut-off suggested by ROC curve analysis, HE4 and ROMA offered better performance compared to CA125 in discriminating ovarian cancer from benign ovarian tumor.