The CA 125 tumour-associated antigen: a review of the literature

Jacobs, Ian; Bast, Robert C.

doi:10.1093/oxfordjournals.humrep.a136832

Cited by 817 publications

(560 citation statements)

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“…Consequently, both markers had poor sensitivity for disease at second-look surgery (Table III). CA125 had a sensitivity of 53%, similar to values quoted in the literature (Jacobs & Bast, 1989), while HMFG2 had a sensitivity of 50% for disease at second-look. Recently, Moscovic et al (1991) found the sensitivity of CA125 to be better than CT scanning prior to second-look surgery.…”

Section: Resultssupporting

confidence: 83%

The value of the human milk fat globule membrane antigen HMFG2 in epithelial ovarian cancer monitoring: comparison with CA125

Fisken

Roulston²,

Sturgeon³

et al. 1993

Br J Cancer

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Summary We assayed serum HMFG2 in serial samples from 215 primary epithelial ovarian cancer patients using an 'in-house' single determinant ELISA. 45% of patients with stage I, 54% with stage II, 61% with stage III and 75% with stage IV disease had elevated serum HMFG2. Post-operative levels were significantly related with residual tumour volume (P < 0.005), and fell in the majority of responders, although the association with response to first-line chemotherapy was not significant. HMFG2 had a sensitivity of 50% specificity of 83%, accuracy of 61%, PVP of 86% and PVN of 45% for disease at second-look laparotomy. Serial levels gave a lead time to clinical relapse in 47% of patients who responded to therapy, including one patient with negative CA125 levels. HMFG2 paralleled CA125 in many respects, although it was elevated in fewer patients. In a stepwise discriminant analysis, HMFG2 added to the discrimination of CA125 (r = 0.183, P < 0.005), although additional accurate information was only given in patients with advanced poorly differentiated serous cystadenocarcinoma. Given that HMFG2 is expressed in few patients who are CA125 negative it is unlikely that it will have a significant clinical impact upon patient management.

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Section: Resultssupporting

confidence: 83%

The value of the human milk fat globule membrane antigen HMFG2 in epithelial ovarian cancer monitoring: comparison with CA125

Fisken

Roulston²,

Sturgeon³

et al. 1993

Br J Cancer

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“…4 The estimated PPV of a similar screening test applied annually to the general population in the United States is lower (14%) because of the slightly higher prevalence of disease observed in the UKCTOCS trial compared with the ovarian cancer incidence in the United States, which was modeled as reported by SEER. Although a PPV >10% often is considered desirable, 32 the costs associated with achieving this may be considerable when applying a multimodality algorithm.…”

Section: Discussionmentioning

confidence: 99%

Development of an ovarian cancer screening decision model that incorporates disease heterogeneity

Havrilesky

Sanders

Kulasingam

et al. 2010

Cancer

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BACKGROUND: Pathologic and genetic data suggest that epithelial ovarian cancer may consist of indolent and aggressive phenotypes. The objective of the current study was to estimate the impact of a 2-phenotype paradigm of epithelial ovarian cancer on the mortality reduction achievable using available screening technologies. METHODS:The authors modified a Markov model of ovarian cancer natural history (the 1-phenotype model) to incorporate aggressive and indolent phenotypes (the 2-phenotype model) based on histopathologic criteria. Stage distribution, incidence, and mortality were calibrated to data from the Surveillance, Epidemiology, and End Results Program of the US National Cancer Institute. For validation, a Monte Carlo microsimulation (1000,000 events) of the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) multimodality prevalence screen was performed. Mortality reduction and positive predictive value (PPV) were estimated for annual screening. RESULTS: In validation against UKCTOCS data, the model-predicted percentage of screen-detected cancers diagnosed at stage I and II was 41% compared with 47% (UKCTOCS data), and the model-predicted PPV of screening was 27% compared with 35% (UKCTOCS data). The model-estimated PPV of a strategy of annual population-based screening in the United States at ages 50 to 85 years was 14%. The mortality reduction using annual postmenopausal screening was 14.7% (1-phenotype model) and 10.9% (2-phenotype model). Mortality reduction was lower with the 2-phenotype model than with the 1-phenotype model regardless of screening frequency or test sensitivity; 68% of cancer deaths are accounted for by the aggressive phenotype. CONCLUSIONS: The current analysis suggested that reductions in ovarian cancer mortality using available screening technologies on an annual basis are likely to be modest. A model that incorporated 2 clinical phenotypes of ovarian carcinoma into its natural history predicted an even smaller potential reduction in mortality because of the more frequent diagnosis of indolent cancers at early stages. Cancer 2011;117:545-53.

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“…Thus, there is a need to detect ovarian cancer when it is suffi ciently small to be curable by existing therapies (1) . Cancer antigen 125 (CA 125) in serum has a high sensitivity for ovarian cancer, but CA 125 levels are frequently elevated in women with benign gynecological diseases, resulting in a reduced specifi city of this marker, especially in premenopausal women (2,3) . Therefore, there is a need for additional markers that can complement CA 125, both for early detection and differential diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Human epididymis protein 4 (HE4) in benign and malignant diseases

Hertlein

Stieber

Kirschenhofer

et al. 2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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Background: Human epididymis protein 4 (HE4) is described as a useful new biomarker in ovarian cancer. As HE4 is neither tumor nor organ specifi c, we intensively investigated the occurrence of this protein in female and male patients with various benign and malignant diseases in order to avoid misinterpretation and to identify potential additional clinical relevance. Methods:We retrospectively investigated HE4 (ARCHITECT ® , Abbott Diagnostics, US) in the sera of 205 healthy individuals, 654 patients with benign disorders and 720 patients with cancer before initial treatment. Results:The lowest concentrations of HE4 were observed in healthy men (median 26.2 pmol/L) followed by healthy women (median 40.4 pmol/L). In benign diseases, highest HE4 concentrations were seen in both women and men with renal failure (women, median 1041 pmol/L; men, median 1368 pmol/L). In women, the highest HE4 levels in malignant diseases were observed in ovarian cancer (median 242 pmol/l), whereas the highest HE4 concentrations in men occurred in lung cancer (median 89.2 pmol/L). The area under the curve (AUC) of HE4 in women was highest in ovarian cancer and borderline tumors as compared to benign gynecological disorders (88.9 % ), with a sensitivity of 67.4 % at 95 % specifi city. Also, signifi cantly elevated concentrations of HE4 with reference to the respective group of benign diseases were observed

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The CA 125 tumour-associated antigen: a review of the literature

Cited by 817 publications

References 0 publications

The value of the human milk fat globule membrane antigen HMFG2 in epithelial ovarian cancer monitoring: comparison with CA125

The value of the human milk fat globule membrane antigen HMFG2 in epithelial ovarian cancer monitoring: comparison with CA125

Development of an ovarian cancer screening decision model that incorporates disease heterogeneity

Human epididymis protein 4 (HE4) in benign and malignant diseases

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