Serum biomarkers detect early-stage ovarian cancer

NEW YORK (Reuters Health) - A panel of four serum biomarkers appear to be effective in detecting early-stage ovarian cancers, according to researchers.

In the June issue of the American Journal of Obstetrics & Gynecology, Dr. Robin Farias-Eisner of the UCLA School of Medicine, Los Angeles, and colleagues note that the widely used serum marker CA-125 will show elevated levels in only about 50% of early-stage ovarian cancers.

To improve these results, the researchers used CA-125 along with the serum proteins apolipoprotein A-1, transthyretin, and transferrin as screening tools to evaluate 358 serum samples. These came from healthy controls, patients with benign adnexal masses, and patients with early- and late-stage ovarian cancer.

Altogether, the panel detected early-stage cancer with a sensitivity of 96% and a specificity of 96%. The highest sensitivity of 98% was seen for detection of the endometrioid subtype of early-stage carcinomas.

Serum CA-125 levels, even when used in combination with transvaginal ultrasound, the researchers point out, "provide sensitivity of no more than 78%."

"Prospective analysis of the panel in (a) clinical setting," the investigators conclude, "is needed next to validate this panel of biomarkers as an effective screening tool."

Nevertheless, Dr. Farias-Eisner told Reuters Health that "the clinical application for our family of differentially expressed proteins, or biomarkers, is to apply them, not as a general screening tool, but rather apply our biomarkers to a population at high risk to develop ovarian cancer."

"This high-risk population," he added, "would include patients with a significant family history of ovarian cancer or patients with BRCA deleterious mutations." They represent "an enriched population in whom the prevalence of ovarian cancer is significantly increased when compared to the general population."

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