New tumor markers: CA125 and beyond
ABSTRACT A variety of biomarkers have been developed to monitor growth of ovarian cancer and to detect disease at an early interval. CA125 (MUC16) has provided a useful serum tumor marker for monitoring response to chemotherapy, detecting disease recurrence, distinguishing malignant from benign pelvic masses, and potentially improving clinical trial design. A rapid fall in CA125 during chemotherapy predicts a favorable prognosis and could be used to redistribute patients on multiarmed randomized clinical trials. Several studies now document that CA125 can serve as a surrogate marker for response in phase II trials. Serial measurement of CA125 might also provide a useful marker for monitoring stabilization of disease with cytostatic targeted therapeutic agents. The greatest potential for serum markers may be in detecting ovarian cancer at an early stage. A rising CA125 can be used to trigger transvaginal sonography (TVS) in a small fraction of patients. An algorithm has been developed that calculates risk of ovarian cancer based on serial CA125 values and refers patients at highest risk for TVS. Use of the algorithm is currently being evaluated in a trial with 200,000 women in the UK that will test critically the ability of a two-stage screening strategy to improve survival in ovarian cancer. Whatever the outcome, as 20% of ovarian cancers have little or no expression of CA125, additional serum markers will be required to detect all patients in an initial phase of screening. More than 30 serum markers have been evaluated alone and in combination with CA125 by different investigators. Some of the most promising include: HE4, mesothelin, M-CSF, osteopontin, kallikrein(s), and soluble EGF receptor. Two proteomic approaches have been used: one examines the pattern of peaks on mass spectroscopy and the other uses proteomic analysis to identify a limited number of critical markers that can be assayed by more conventional methods. Both approaches are promising and require further development. Several groups are placing markers on multiplex platforms to permit simultaneous assay of multiple markers with very small volumes of serum. Mathematical techniques are being developed to analyze combinations of marker levels to improve sensitivity and specificity. In the future, serum markers should improve the sensitivity of detecting recurrent disease as well as facilitate earlier detection of ovarian cancer.
- SourceAvailable from: Kerem Doğa Seçkin
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- "Today, the most commonly used combination is that in which CA-125 and imaging methods are used together (Ashrafgangooei and Rezaeezadeh, 2011). However, this combination is not sufficient for early diagnosis due to the low sensitivity of CA-125 and the cost of imaging methods (Bast et al., 2005). Therefore, development a new marker to increase the early detection rate is necessary. "
ABSTRACT: The present study aimed to investigate the utility and importance of the various parameters of complete blood count panel for benign-malignant differentiation of adnexal masses.Asian Pacific journal of cancer prevention: APJCP 08/2014; 15(16):6881-5. DOI:10.7314/APJCP.2014.15.16.6881 · 2.51 Impact Factor
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- "Among gynecologic malignancies, epithelial ovarian cancer (EOC) is the leading cause of death (Kohler et al., 2011). Most EOC cases are diagnosed at an advanced stage of the disease because the premalignant state is poorly understood and an efficient screening strategy is not presently available (Bast et al., 2005). Although improvements in primary treatment, often consisting of cytoreductive surgery and platinum-based chemotherapy, have been made, the majority of these patients continue to experience relapses and eventually die from the disease (Bookman, 2003; Bast et al., 2009). "
ABSTRACT: Stress-induced phosphoprotein1 (STIP1) is a candidate biomarker in epithelial ovarian cancer (EOC). In this study, we investigated in detail the expression of STIP1, as well as its functions, in EOC. STIP1 expression was assessed by immunohistochemistry (IHC) and the results were compared with clinicopathologic factors, including survival data. The effects of STIP1 gene silencing via small interfering RNA (siRNA) were examined in EOC cells and a xenograft model. The expression of STIP1 protein in EOC was significantly higher than in the other study groups (P < 0.001), and this increase of expression was significantly associated with tumor stage (P = 0.005), tumor grade (P = 0.029), and lymph node metastasis (P = 0.020). In multivariate analysis, overall survival in EOC was significantly shorter in cases with high STIP1 expression (HR = 2.78 [1.01-7.63], P = 0.047). STIP1 silencing in EOC cells resulted in inhibition of cell proliferation and invasion. In addition, in vivo experiments using STIP1 siRNA clearly showed a strong inhibition of tumor growth and a modulation of expression of prosurvival and apoptotic genes, further suggesting that STIP1 silencing can prevent cell proliferation and invasion. In conclusion, increased STIP1 expression is associated with poor survival outcome in EOC, and STIP1 may represent a useful therapeutic target in EOC patients. © 2014 Wiley Periodicals, Inc.Genes Chromosomes and Cancer 04/2014; 53(4). DOI:10.1002/gcc.22136 · 3.84 Impact Factor
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- "But neither of these tests are sufficiently sensitive or specific . Recently, biomarkers such as CA125 and CA19-9 have been used to help in the early screening and diagnosis of ovarian cancer i.e. at a stage when it is the most treatable and before it has had a chance to grow and spread    . CA125 is the most widely used tumor marker in ovarian cancer but its sensitivity and specificity are not ideal because the levels of this marker are raised to approximately 80% of all epithelial ovarian cancers (EOC) and in only 50% of stage I EOC. "
ABSTRACT: The application of serum biomarker to ovarian tumors for early stage detection and clinical diagnosis is a rapidly expanding research area. The problem with conventional markers is that they are often released too late or at too low a level to be detected in time to trigger effective treatment. Ultrasound has been used to influence bio-effects in living cells, but there is only one reported case of the use of ultrasound to enhance the release of a biomarker (Carcinoembryonic antigen CEA). In this study we report the use of ultrasound to enhance the release of a combination of ovarian cancer biomarkers (CA125 and CA19-9) to help in the diagnosis of ovarian cancer at an early stage. The results indicated that after 5min sonication at a frequency of 1MHz and intensity of 0.3Wcm(-2), the CA125 and CA19-9 levels were increased by 2.02 and 4.21-fold respectively. These findings suggest that ultrasonic treatment can be used to enhance the release of serum biomarkers from ovarian tumors.Ultrasonics 02/2014; 54(2):451-454. DOI:10.1016/j.ultras.2013.05.014 · 1.81 Impact Factor