Performance of TEPOC and CA125 to detect ovarian cancer in validation cohorts.
| . | AUC (95% CI) . | ACC (95% CI), % . | SN (95% CI), % . | SP (95% CI), % . | PPV (95% CI), % . | NPV (95% CI), % . | Kappa . | F1 . | AUC P-value . |
|---|---|---|---|---|---|---|---|---|---|
| All validation | |||||||||
| TEPOC | 0.918 (0.889–0.948) | 83.8 (79.6–87.4) | 85.3 (78.7–90.4) | 82.7 (76.9–87.6) | 78.7 (71.7–84.6) | 88.2 (82.8–92.4) | 0.672 | 0.818 | <0.001 |
| CA125 | 0.804 (0.750–0.857) | 75.9 (70.4–80.9) | 78.6 (71.2–84.8) | 72.4 (63.3–80.3) | 79.1 (71.8–85.2) | 71.8 (62.7–79.7) | 0.509 | 0.788 | — |
| TEPOC+CA125 | 0.922 (0.889–0.955) | 85.9 (81.2–89.8) | 86.4 (79.9–91.4) | 85.3 (77.6–91.2) | 88.7 (82.5–93.3) | 82.5 (74.5–88.8) | 0.714 | 0.875 | <0.001 |
| VC1 | |||||||||
| TEPOC | 0.923 (0.855–0.990) | 84.9 (74.6–92.2) | 95.0 (83.1–99.4) | 72.7 (54.5–86.7) | 80.9 (66.7–90.9) | 92.3 (74.9–99.1) | 0.690 | 0.874 | 0.013 |
| CA125 | 0.735 (0.615–0.855) | 75.3 (63.9–84.7) | 82.5 (67.2–92.7) | 66.7 (48.2–82.0) | 75.0 (59.7–86.8) | 75.9 (56.5–89.7) | 0.497 | 0.786 | — |
| TEPOC+CA125 | 0.955 (0.912–0.997) | 87.7 (77.9–94.2) | 92.5 (79.6–98.4) | 81.8 (64.5–93.0) | 86.0 (72.1–94.7) | 90.0 (73.5–97.9) | 0.749 | 0.892 | <0.001 |
| VC2 | |||||||||
| TEPOC | 0.918 (0.872–0.963) | 84.0 (77.4–89.2) | 86.2 (77.1–92.7) | 81.3 (70.7–89.4) | 84.3 (75.0–91.1) | 83.6 (73.0–91.2) | 0.677 | 0.852 | 0.033 |
| CA125 | 0.836 (0.774–0.899) | 77.2 (69.9–83.4) | 79.3 (69.3–87.3) | 74.7 (63.3–84.0) | 78.4 (68.4–86.5) | 75.7 (64.3–84.9) | 0.540 | 0.789 | — |
| TEPOC+CA125 | 0.939 (0.901–0.977) | 87.7 (81.6–92.3) | 89.7 (81.3–95.2) | 85.3 (75.3–92.4) | 87.6 (79.0–93.7) | 87.7 (77.9–94.2) | 0.751 | 0.886 | 0.002 |
| VC3 | |||||||||
| TEPOC | 0.887 (0.813–0.960) | 82.9 (75.3–89.0) | 69.0 (49.2–84.7) | 87.0 (78.8–92.9) | 60.6 (42.1–77.1) | 90.6 (82.9–95.6) | 0.534 | 0.645 | 0.491 |
| CA125 | 0.824 (0.663–0.985) | 71.4 (53.7–85.4) | 70.4 (49.8–86.2) | 75.0 (34.9–96.8) | 90.5 (69.6–98.8) | 42.9 (17.7–71.1) | 0.359 | 0.792 | — |
| TEPOC+CA125 | 0.917 (0.824–1.000) | 74.3 (56.7–87.5) | 66.7 (46.0–83.5) | 100.0 (63.1–100.0) | 100.0 (81.5–100.0) | 47.1 (23.0–72.2) | 0.478 | 0.800 | 0.284 |
| . | AUC (95% CI) . | ACC (95% CI), % . | SN (95% CI), % . | SP (95% CI), % . | PPV (95% CI), % . | NPV (95% CI), % . | Kappa . | F1 . | AUC P-value . |
|---|---|---|---|---|---|---|---|---|---|
| All validation | |||||||||
| TEPOC | 0.918 (0.889–0.948) | 83.8 (79.6–87.4) | 85.3 (78.7–90.4) | 82.7 (76.9–87.6) | 78.7 (71.7–84.6) | 88.2 (82.8–92.4) | 0.672 | 0.818 | <0.001 |
| CA125 | 0.804 (0.750–0.857) | 75.9 (70.4–80.9) | 78.6 (71.2–84.8) | 72.4 (63.3–80.3) | 79.1 (71.8–85.2) | 71.8 (62.7–79.7) | 0.509 | 0.788 | — |
| TEPOC+CA125 | 0.922 (0.889–0.955) | 85.9 (81.2–89.8) | 86.4 (79.9–91.4) | 85.3 (77.6–91.2) | 88.7 (82.5–93.3) | 82.5 (74.5–88.8) | 0.714 | 0.875 | <0.001 |
| VC1 | |||||||||
| TEPOC | 0.923 (0.855–0.990) | 84.9 (74.6–92.2) | 95.0 (83.1–99.4) | 72.7 (54.5–86.7) | 80.9 (66.7–90.9) | 92.3 (74.9–99.1) | 0.690 | 0.874 | 0.013 |
| CA125 | 0.735 (0.615–0.855) | 75.3 (63.9–84.7) | 82.5 (67.2–92.7) | 66.7 (48.2–82.0) | 75.0 (59.7–86.8) | 75.9 (56.5–89.7) | 0.497 | 0.786 | — |
| TEPOC+CA125 | 0.955 (0.912–0.997) | 87.7 (77.9–94.2) | 92.5 (79.6–98.4) | 81.8 (64.5–93.0) | 86.0 (72.1–94.7) | 90.0 (73.5–97.9) | 0.749 | 0.892 | <0.001 |
| VC2 | |||||||||
| TEPOC | 0.918 (0.872–0.963) | 84.0 (77.4–89.2) | 86.2 (77.1–92.7) | 81.3 (70.7–89.4) | 84.3 (75.0–91.1) | 83.6 (73.0–91.2) | 0.677 | 0.852 | 0.033 |
| CA125 | 0.836 (0.774–0.899) | 77.2 (69.9–83.4) | 79.3 (69.3–87.3) | 74.7 (63.3–84.0) | 78.4 (68.4–86.5) | 75.7 (64.3–84.9) | 0.540 | 0.789 | — |
| TEPOC+CA125 | 0.939 (0.901–0.977) | 87.7 (81.6–92.3) | 89.7 (81.3–95.2) | 85.3 (75.3–92.4) | 87.6 (79.0–93.7) | 87.7 (77.9–94.2) | 0.751 | 0.886 | 0.002 |
| VC3 | |||||||||
| TEPOC | 0.887 (0.813–0.960) | 82.9 (75.3–89.0) | 69.0 (49.2–84.7) | 87.0 (78.8–92.9) | 60.6 (42.1–77.1) | 90.6 (82.9–95.6) | 0.534 | 0.645 | 0.491 |
| CA125 | 0.824 (0.663–0.985) | 71.4 (53.7–85.4) | 70.4 (49.8–86.2) | 75.0 (34.9–96.8) | 90.5 (69.6–98.8) | 42.9 (17.7–71.1) | 0.359 | 0.792 | — |
| TEPOC+CA125 | 0.917 (0.824–1.000) | 74.3 (56.7–87.5) | 66.7 (46.0–83.5) | 100.0 (63.1–100.0) | 100.0 (81.5–100.0) | 47.1 (23.0–72.2) | 0.478 | 0.800 | 0.284 |
Predictions of TEPOC and the combination model were compared with those of CA125 using a two-sided DeLong’s test (AUC P-value). Abbreviations: TEPOC, tumor-educated platelet-derived gene panel of ovarian cancer; CA125, cancer antigen 125; TEPOC+CA125, the combination of TEPOC and CA125; AUC, area under the curve; ACC, accuracy; SN, sensitivity; SP, specificity; PPV, positive predictive value; NPV, negative predictive value; CI, confidence interval.
Performance of TEPOC and CA125 to detect ovarian cancer in validation cohorts.
| . | AUC (95% CI) . | ACC (95% CI), % . | SN (95% CI), % . | SP (95% CI), % . | PPV (95% CI), % . | NPV (95% CI), % . | Kappa . | F1 . | AUC P-value . |
|---|---|---|---|---|---|---|---|---|---|
| All validation | |||||||||
| TEPOC | 0.918 (0.889–0.948) | 83.8 (79.6–87.4) | 85.3 (78.7–90.4) | 82.7 (76.9–87.6) | 78.7 (71.7–84.6) | 88.2 (82.8–92.4) | 0.672 | 0.818 | <0.001 |
| CA125 | 0.804 (0.750–0.857) | 75.9 (70.4–80.9) | 78.6 (71.2–84.8) | 72.4 (63.3–80.3) | 79.1 (71.8–85.2) | 71.8 (62.7–79.7) | 0.509 | 0.788 | — |
| TEPOC+CA125 | 0.922 (0.889–0.955) | 85.9 (81.2–89.8) | 86.4 (79.9–91.4) | 85.3 (77.6–91.2) | 88.7 (82.5–93.3) | 82.5 (74.5–88.8) | 0.714 | 0.875 | <0.001 |
| VC1 | |||||||||
| TEPOC | 0.923 (0.855–0.990) | 84.9 (74.6–92.2) | 95.0 (83.1–99.4) | 72.7 (54.5–86.7) | 80.9 (66.7–90.9) | 92.3 (74.9–99.1) | 0.690 | 0.874 | 0.013 |
| CA125 | 0.735 (0.615–0.855) | 75.3 (63.9–84.7) | 82.5 (67.2–92.7) | 66.7 (48.2–82.0) | 75.0 (59.7–86.8) | 75.9 (56.5–89.7) | 0.497 | 0.786 | — |
| TEPOC+CA125 | 0.955 (0.912–0.997) | 87.7 (77.9–94.2) | 92.5 (79.6–98.4) | 81.8 (64.5–93.0) | 86.0 (72.1–94.7) | 90.0 (73.5–97.9) | 0.749 | 0.892 | <0.001 |
| VC2 | |||||||||
| TEPOC | 0.918 (0.872–0.963) | 84.0 (77.4–89.2) | 86.2 (77.1–92.7) | 81.3 (70.7–89.4) | 84.3 (75.0–91.1) | 83.6 (73.0–91.2) | 0.677 | 0.852 | 0.033 |
| CA125 | 0.836 (0.774–0.899) | 77.2 (69.9–83.4) | 79.3 (69.3–87.3) | 74.7 (63.3–84.0) | 78.4 (68.4–86.5) | 75.7 (64.3–84.9) | 0.540 | 0.789 | — |
| TEPOC+CA125 | 0.939 (0.901–0.977) | 87.7 (81.6–92.3) | 89.7 (81.3–95.2) | 85.3 (75.3–92.4) | 87.6 (79.0–93.7) | 87.7 (77.9–94.2) | 0.751 | 0.886 | 0.002 |
| VC3 | |||||||||
| TEPOC | 0.887 (0.813–0.960) | 82.9 (75.3–89.0) | 69.0 (49.2–84.7) | 87.0 (78.8–92.9) | 60.6 (42.1–77.1) | 90.6 (82.9–95.6) | 0.534 | 0.645 | 0.491 |
| CA125 | 0.824 (0.663–0.985) | 71.4 (53.7–85.4) | 70.4 (49.8–86.2) | 75.0 (34.9–96.8) | 90.5 (69.6–98.8) | 42.9 (17.7–71.1) | 0.359 | 0.792 | — |
| TEPOC+CA125 | 0.917 (0.824–1.000) | 74.3 (56.7–87.5) | 66.7 (46.0–83.5) | 100.0 (63.1–100.0) | 100.0 (81.5–100.0) | 47.1 (23.0–72.2) | 0.478 | 0.800 | 0.284 |
| . | AUC (95% CI) . | ACC (95% CI), % . | SN (95% CI), % . | SP (95% CI), % . | PPV (95% CI), % . | NPV (95% CI), % . | Kappa . | F1 . | AUC P-value . |
|---|---|---|---|---|---|---|---|---|---|
| All validation | |||||||||
| TEPOC | 0.918 (0.889–0.948) | 83.8 (79.6–87.4) | 85.3 (78.7–90.4) | 82.7 (76.9–87.6) | 78.7 (71.7–84.6) | 88.2 (82.8–92.4) | 0.672 | 0.818 | <0.001 |
| CA125 | 0.804 (0.750–0.857) | 75.9 (70.4–80.9) | 78.6 (71.2–84.8) | 72.4 (63.3–80.3) | 79.1 (71.8–85.2) | 71.8 (62.7–79.7) | 0.509 | 0.788 | — |
| TEPOC+CA125 | 0.922 (0.889–0.955) | 85.9 (81.2–89.8) | 86.4 (79.9–91.4) | 85.3 (77.6–91.2) | 88.7 (82.5–93.3) | 82.5 (74.5–88.8) | 0.714 | 0.875 | <0.001 |
| VC1 | |||||||||
| TEPOC | 0.923 (0.855–0.990) | 84.9 (74.6–92.2) | 95.0 (83.1–99.4) | 72.7 (54.5–86.7) | 80.9 (66.7–90.9) | 92.3 (74.9–99.1) | 0.690 | 0.874 | 0.013 |
| CA125 | 0.735 (0.615–0.855) | 75.3 (63.9–84.7) | 82.5 (67.2–92.7) | 66.7 (48.2–82.0) | 75.0 (59.7–86.8) | 75.9 (56.5–89.7) | 0.497 | 0.786 | — |
| TEPOC+CA125 | 0.955 (0.912–0.997) | 87.7 (77.9–94.2) | 92.5 (79.6–98.4) | 81.8 (64.5–93.0) | 86.0 (72.1–94.7) | 90.0 (73.5–97.9) | 0.749 | 0.892 | <0.001 |
| VC2 | |||||||||
| TEPOC | 0.918 (0.872–0.963) | 84.0 (77.4–89.2) | 86.2 (77.1–92.7) | 81.3 (70.7–89.4) | 84.3 (75.0–91.1) | 83.6 (73.0–91.2) | 0.677 | 0.852 | 0.033 |
| CA125 | 0.836 (0.774–0.899) | 77.2 (69.9–83.4) | 79.3 (69.3–87.3) | 74.7 (63.3–84.0) | 78.4 (68.4–86.5) | 75.7 (64.3–84.9) | 0.540 | 0.789 | — |
| TEPOC+CA125 | 0.939 (0.901–0.977) | 87.7 (81.6–92.3) | 89.7 (81.3–95.2) | 85.3 (75.3–92.4) | 87.6 (79.0–93.7) | 87.7 (77.9–94.2) | 0.751 | 0.886 | 0.002 |
| VC3 | |||||||||
| TEPOC | 0.887 (0.813–0.960) | 82.9 (75.3–89.0) | 69.0 (49.2–84.7) | 87.0 (78.8–92.9) | 60.6 (42.1–77.1) | 90.6 (82.9–95.6) | 0.534 | 0.645 | 0.491 |
| CA125 | 0.824 (0.663–0.985) | 71.4 (53.7–85.4) | 70.4 (49.8–86.2) | 75.0 (34.9–96.8) | 90.5 (69.6–98.8) | 42.9 (17.7–71.1) | 0.359 | 0.792 | — |
| TEPOC+CA125 | 0.917 (0.824–1.000) | 74.3 (56.7–87.5) | 66.7 (46.0–83.5) | 100.0 (63.1–100.0) | 100.0 (81.5–100.0) | 47.1 (23.0–72.2) | 0.478 | 0.800 | 0.284 |
Predictions of TEPOC and the combination model were compared with those of CA125 using a two-sided DeLong’s test (AUC P-value). Abbreviations: TEPOC, tumor-educated platelet-derived gene panel of ovarian cancer; CA125, cancer antigen 125; TEPOC+CA125, the combination of TEPOC and CA125; AUC, area under the curve; ACC, accuracy; SN, sensitivity; SP, specificity; PPV, positive predictive value; NPV, negative predictive value; CI, confidence interval.
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