title: Lysophosphatidic acid as a potential biomarker for ovarian and other gynecologic cancers.
abstract: BACKGROUND
  Lysophosphatidic acid (LPA) has been shown to stimulate proliferation of ovarian cancer cells and is present in the ascitic fluid of patients with ovarian cancer.
  
  
  OBJECTIVE
  To determine whether elevated levels of LPA are present in plasma from patients with ovarian cancer and other gynecologic malignancies compared with healthy controls and to evaluate whether an elevated LPA plasma level may be a biomarker for these diseases.
  
  
  METHODS
  A research assay was used to measure total LPA levels in plasma from healthy women and women with different diseases. All LPA assays and comparison of LPA levels and CA125 (an ovarian cancer biomarker) levels were performed by observers blinded to patient status or group.
  
  
  METHODS
  The Cleveland Clinic Foundation.
  
  
  METHODS
  A convenience sample of 48 healthy control women, 48 women with ovarian cancer, 36 women with other gynecologic cancers, 17 women with benign gynecologic diseases, 11 women with breast cancer, and 5 women with leukemias.
  
  
  METHODS
  Total LPA levels in plasma samples from patients and controls.
  
  
  RESULTS
  Patients in the ovarian cancer group had significantly higher plasma LPA levels (mean, 8.6 micromol/L; range, 1.0-43.1 micromol/L) compared with the healthy control group (mean, 0.6 micromol/L; range, <0.1-6.3 micromol/L) (P<.001). Elevated plasma LPA levels were detected in 9 of 10 patients with stage I ovarian cancer, 24 of 24 patients with stage II, III, and IV ovarian cancer, and 14 of 14 patients with recurrent ovarian cancer. Of 36 patients with other gynecologic cancers, 33 also showed higher LPA levels(mean, 14.9 micromol/L; range, <0.1-63.2 pmol/L), compared with healthy controls (P<.001). Elevated plasma LPA levels were detected in 5 of 48 controls and 4 of 17 patients with benign gynecologic diseases and in no women with breast cancer or leukemia. In comparison, among a subset of patients with ovarian cancer, 28 of 47 had elevated CA125 levels, including 2 of 9 patients with stage I disease.
  
  
  CONCLUSIONS
  Plasma LPA levels may represent a potential biomarker for ovarian cancer and other gynecologic cancers. However, these findings are preliminary and require confirmation in larger studies.
authors.affiliation: Department of Gynecology and Obstetrics, Cancer Center, Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Xu
authors.forename: Z
authors.initials: Z
authors.lastname: Shen
authors.forename: D W
authors.initials: DW
authors.lastname: Wiper
authors.forename: M
authors.initials: M
authors.lastname: Wu
authors.forename: R E
authors.initials: RE
authors.lastname: Morton
authors.forename: P
authors.initials: P
authors.lastname: Elson
authors.forename: A W
authors.initials: AW
authors.lastname: Kennedy
authors.forename: J
authors.initials: J
authors.lastname: Belinson
authors.forename: M
authors.initials: M
authors.lastname: Markman
authors.forename: G
authors.initials: G
authors.lastname: Casey
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D005833:Genital Neoplasms, Female / Q000097:blood*; D006801:Humans; D008246:Lysophospholipids / Q000097:blood*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood*; D011237:Predictive Value of Tests; D018709:Statistics, Nonparametric
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D008246:Lysophospholipids