Ovarian Cancer

Patriotis, Christos; Simmons, Archana R.; Lu, Karen H.; Bast, Robert C.; Skates, Steven J.

doi:10.1002/9781118468869.ch8

Cited by 5 publications

(7 citation statements)

References 56 publications

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“…However, significant increase in the level of CA 125 was found in adenomyosis, uterine myoma, endometrial pathology, and endometriosis of the ovary (Kim et al, 2019). Moreover, CA125 is not only increased in about 80 % of ovarian cancer but also 50 % rises are observed in stage I epithelial ovarian cancers (Patriotis et al, 2017;Zurawski et al, 1988). Therefore, using CA125 as the only biomarker for diagnosis will miss out those which do not express this antigen.…”

Section: Present Diagnostic Biomarkers Of Early-stage Ovarian Cancermentioning

confidence: 99%

Multi-biomarker panel signature as the key to diagnosis of ovarian cancer

Muinao

Boruah

Pal

2019

Heliyon

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Early detection of ovarian cancer has been a challenge to manage the high mortality rate caused by this deadly disease. The trends in mortality have been reduced by the scientific contributions from the corners across the globe, however accounting for the fifth leading cause of gynecological mortality. The complexities in the clinical presentation, origin of tumor, and gene expression profiles had added to much difficulty in understanding and diagnosis of the disease. Stage 1 diagnosis of ovarian cancer improves the 5-year survival rate to around 92%. Cancer antigen-125 (CA-125) is the gold standard tumor marker found at abnormally high levels in the blood of many women in ovarian cancer. However, many non-cancerous conditions exhibit high levels of CA-125 and several women have normal CA-125 level in the early stage of ovarian cancer, suggesting CA-125 biomarker is not specific enough for the screening of early stage ovarian cancer. In addition, several other biomarkers, including HE4 have been added in the diagnostic field for higher sensitivity and specificity in the diagnosis and progression of ovarian cancer. HE4 is a prospective single serum biomarker which has been approved by the FDA to monitor the disease progression in epithelial ovarian cancer. However, owing to low sensitivity and specificity, combination of a panel of biomarkers has been proposed in the diagnosis of the disease. Based on extensive biomarkers research findings, here we discuss current trends in diagnostic approaches and updated potential several panels of cancer biomarkers for early detection of ovarian cancer. It has been recently reported that CA125 in combinations with two or more biomarkers have outperformed single biomarker assays for early detection of the disease. Moreover, CA-125 with CA 19–9, EGFR, G-CSF, Eotaxin, IL-2R, cVCAM, MIF improved the sensitivity with 98.2 % and specificity of 98.7% in early stage detection of ovarian cancer. Overall, this review demonstrates a panel of biomarkers signature as the potential tool for prototype development in future and other advanced approaches for early diagnosis of ovarian cancer to avoid false-diagnosis and excessive cost.

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Section: Present Diagnostic Biomarkers Of Early-stage Ovarian Cancermentioning

confidence: 99%

Multi-biomarker panel signature as the key to diagnosis of ovarian cancer

Muinao

Boruah

Pal

2019

Heliyon

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“…The conventional view of ovarian carcinogenesis has been that epithelial ovarian most cancers originate from the ovarian floor mesothelial epithelium, or coelomic epithelium [1]. This epithelium undergoes metaplasia to müllerian epithelium which, morphologically, resembles the epithelia of the fallopian tube, endometrium, gastrointestinal tract, endocervix, and urinary bladder.…”

Section: Surfacementioning

confidence: 99%

“…Recent morphologic and molecular genetic research have shed light on our information of ovarian carcinogenesis in approaches that have been pretty sudden and feature challenged traditional awareness concerning their foundation and improvement. Indeed, they have led to a paradigm shift that has critical implications for research and substantially converting our tactics to early detection, prevention, and remedy [1].…”

Section: Introductionmentioning

confidence: 99%

Ovarian Cancer is the Deadliest of all Gynecological Tumors

Franjić¹

2023

MJGO

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Ovarian cancer is the seventh most common cancer among women in the world. It accounts for only 4% of all cancers in women, but the devastating information is that it is the deadliest of all gynecological tumors. The reason for this is its late detection in an already advanced stage when treatment options are already very limited. The cause of ovarian cancer is unknown. Among the factors that have an impact on development, the following are important: age, the occurrence of cancer in the family, the reproductive function of a woman, and environmental factors. The symptoms of ovarian cancer are non-specific and often go unrecognized, even though they appear even in the early stages of the disease. Because of this, a large number of cases, even 70%, are discovered when cancer has already spread.

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“…Ovarian cancer is neither a common nor a rare disease with a prevalence of 1 in 2500 in postmenopausal women at highest risk. As a result, a very high specificity (>99.6%) and at least moderate sensitivity (>75%) is required for a screening strategy in the general population to achieve a positive predictive value (PPV) of 10% i.e., 10 operations per case of ovarian cancer (2). Currently, while the multimodal screening strategy achieves these performance characteristics, it is not recommended by the United States Preventive Services Task Force (USPSTF) in asymptomatic women at normal risk for ovarian cancer as there is as yet no evidence of a definitive mortality benefit (3).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the promise of two-stage multi-modal strategies, 15–20% of ovarian cancers do not express CA125 and will be missed by CA125 alone (2). Several combinations of multiple marker panels have been proposed (most in combination with CA125) that improve sensitivity, while maintaining specificity compared to CA125 alone (11,12).…”

Section: Introductionmentioning

confidence: 99%

Complementary Longitudinal Serum Biomarkers to CA125 for Early Detection of Ovarian Cancer

Simmons

Fourkala

Gentry‐Maharaj

et al. 2019

Cancer Prevention Research

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Early detection of ovarian cancer has the potential to impact mortality. A multi-modal screening strategy where rising CA125 values over time, analyzed with the risk of ovarian cancer algorithm (ROCA), triggers transvaginal sonography and possible surgery has high sensitivity and specificity, but still fails to detect the 20% of early stage cases that do not express CA125. Use of multiple biomarkers could detect cases missed by CA125. We have studied the sensitivity and lead time of a multi-marker panel (CA125, HE4, MMP-7 and CA 72–4) compared to CA125 alone. We used PRoBE design principles to select pre-clinical longitudinal specimens from 75 women (50 screen-positive, 25 screen-negative) who developed invasive epithelial ovarian cancer (3–5 serial specimens each) and 547 corresponding healthy controls (1–10 serial specimens each) from the ovarian cancer screening trial, UKCTOCS, in a blinded fashion. We measured the multi-marker concentrations in ultra-low serum volumes (16 μL) utilizing multiplexed bead-based immunoassays with low detection limits, high inter- and intra-assay precision, negligible cross-reactivity and good correlation with standard immunoassays. While, at least one of the complementary biomarkers rose with CA125 in 44% (22/50) of screen-positive cases, there was no advantage in lead time over CA125. Therefore, we developed single-marker longitudinal algorithms (ROCA-like) to determine the presence of a change point to distinguish between the cases and controls. Using these algorithms, at 98% specificity, HE4 and CA72–4 identified 16% (4/25) of screen-negative cases, while MMP-7 identified none. Taken together, HE4 and CA72–4 show promise as complementary biomarkers to CA125 for longitudinal screening.

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Ovarian Cancer

Cited by 5 publications

References 56 publications

Multi-biomarker panel signature as the key to diagnosis of ovarian cancer

Multi-biomarker panel signature as the key to diagnosis of ovarian cancer

Ovarian Cancer is the Deadliest of all Gynecological Tumors

Complementary Longitudinal Serum Biomarkers to CA125 for Early Detection of Ovarian Cancer

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