title: Combinations of multiple serum markers are superior to individual assays for discriminating malignant from benign pelvic masses.
abstract: To determine whether measurement of the levels of multiple tumor markers in the preoperative serum of women presenting with a pelvic mass distinguished benign from malignant disease better than the assay of CA 125 alone, sera from 429 patients, 192 of whom had malignant histology, were assayed for 8 different markers: CA 125, macrophage colony-stimulating factor, OVX1, lipid-associated sialic acid (LASA), CA15-3, CA72-4, CA19-9, and CA54/61. The sensitivity and specificity of CA 125 alone (> 35 U/ml) was 78.1 and 76.8%, respectively. A panel consisting of CA 125, OVX1, LASA, CA15-3, and CA72-4 had a sensitivity of 83.3% and specificity of 84.0% when two or more markers were elevated. Using the concentrations of these five markers, logistic regression analysis had a sensitivity of 85.4% and a specificity of 83.1%. Considering the values of markers in different sequences, classification and regression tree analysis substantially improved the sensitivity to 90.6% and the specificity to 93.2%. When applied in clinical practice this approach could improve the management of women presenting with a pelvic mass and may also have application in screening for ovarian cancer.
authors.affiliation: Department of Medicine, Duke University Medical Center, Duke Comprehensive Cancer Center, Durham, North Carolina 27110, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Woolas
authors.forename: M R
authors.initials: MR
authors.lastname: Conaway
authors.forename: F
authors.initials: F
authors.lastname: Xu
authors.forename: I J
authors.initials: IJ
authors.lastname: Jacobs
authors.forename: Y
authors.initials: Y
authors.lastname: Yu
authors.forename: L
authors.initials: L
authors.lastname: Daly
authors.forename: A P
authors.initials: AP
authors.lastname: Davies
authors.forename: K
authors.initials: K
authors.lastname: O'Briant
authors.forename: A
authors.initials: A
authors.lastname: Berchuck
authors.forename: J T
authors.initials: JT
authors.lastname: Soper
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016015:Logistic Models; D010386:Pelvic Neoplasms / Q000097:blood / Q000473:pathology*; D011300:Preoperative Care; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor