title: Serum inhibin, activin and follistatin in postmenopausal women with epithelial ovarian carcinoma.
abstract: OBJECTIVE
  To investigate the role of serum inhibin A, inhibin pro-alphaC immunoreactivity, activin A, and follistatin in postmenopausal women with epithelial ovarian cancer.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  e Serum samples from 27 postmenopausal women with epithelial ovarian cancer and 54 controls from the general population participating in an ovarian cancer screening trial.
  
  
  RESULTS
  Women with epithelial ovarian cancer had significantly higher serum levels of pro-alphaC immunoreactivity (P = 0.03), activin A (P = 0.004) and follistatin (P = 0.04), but not inhibin A (P = 0.13). Using the 90th centile in the control group as the cut off, pro-alphaC levels were elevated in 41% of women with epithelial ovarian cancer, while inhibin A was elevated in only 15%. Using the 95th centile as the cut off, serum pro-alphaC was elevated in only 11% of women with epithelial ovarian cancer (3/27), while activin A was elevated in 48% (11/23). Follicle stimulating hormone levels were significantly lower in women with epithelial ovarian cancer (P = 0.01). Although, inhibin-related peptides can modulate follicle stimulating hormone levels, there was no correlation between inhibin A, pro-alphaC immunoreactivity, activin A or follistatin and follicle stimulating hormone.
  
  
  CONCLUSIONS
  These data demonstrate that though there is preferential secretion of precursor forms of the alpha subunit rather than dimeric inhibin A by epithelial ovarian cancer, pro-alphaC is unlikely to be a useful tumour marker. Activin A is more commonly elevated in postmenopausal women with epithelial ovarian cancer and its role as a tumour marker in the diagnosis and screening of epithelial ovarian cancer warrants further evaluation.
authors.affiliation: Department of Gynaecological Oncology, St Bartholomew's Hospital, Royal London School of Medicine and Dentistry, West Smithfield, UK.
authors.forename: U
authors.initials: U
authors.lastname: Menon
authors.forename: S C
authors.initials: SC
authors.lastname: Riley
authors.forename: J
authors.initials: J
authors.lastname: Thomas
authors.forename: C
authors.initials: C
authors.lastname: Bose
authors.forename: A
authors.initials: A
authors.lastname: Dawnay
authors.forename: L W
authors.initials: LW
authors.lastname: Evans
authors.forename: N P
authors.initials: NP
authors.lastname: Groome
authors.forename: I J
authors.initials: IJ
authors.lastname: Jacobs
mesh_terms: D028341:Activins; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002278:Carcinoma in Situ / Q000097:blood* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D038681:Follistatin; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007118:Immunoassay; D007265:Inhibins / Q000097:blood*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood* / Q000473:pathology; D017698:Postmenopause / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D038681:Follistatin; D006023:Glycoproteins; D028341:Activins; D007265:Inhibins