Three biomarkers identified from serum proteomic analysis for the detection of early stage ovarian cancer.
Early detection remains the most promising approach to improve long-term survival of patients with ovarian cancer. In a five-center case-control study, serum proteomic expressions were analyzed on 153 patients with invasive epithelial ovarian cancer, 42 with other ovarian cancers, 166 with benign pelvic masses, and 142 healthy women. Data from patients with early stage ovarian cancer and healthy women at two centers were analyzed independently and the results cross-validated to discover potential biomarkers. The results were validated using the samples from two of the remaining centers. After protein identification, biomarkers for which an immunoassay was available were tested on samples from the fifth center, which included 41 healthy women, 41 patients with ovarian cancer, and 20 each with breast, colon, and prostate cancers. Three biomarkers were identified as follows: (a) apolipoprotein A1 (down-regulated in cancer); (b) a truncated form of transthyretin (down-regulated); and (c) a cleavage fragment of inter-alpha-trypsin inhibitor heavy chain H4 (up-regulated). In independent validation to detect early stage invasive epithelial ovarian cancer from healthy controls, the sensitivity of a multivariate model combining the three biomarkers and CA125 [74% (95% CI, 52-90%)] was higher than that of CA125 alone [65% (95% CI, 43-84%)] at a matched specificity of 97% (95% CI, 89-100%). When compared at a fixed sensitivity of 83% (95% CI, 61-95%), the specificity of the model [94% (95% CI, 85-98%)] was significantly better than that of CA125 alone [52% (95% CI, 39-65%)]. These biomarkers demonstrated the potential to improve the detection of early stage ovarian cancer.
Zhang
Zhen
Z
Department of Pathology, Biomarker Discovery Center, Johns Hopkins Medical Institutions, Baltimore, Maryland 21231, USA. zzhang7@jhmi.edu
Bast
Robert C
RC
Yu
Yinhua
Y
Li
Jinong
J
Sokoll
Lori J
LJ
Rai
Alex J
AJ
Rosenzweig
Jason M
JM
Cameron
Bonnie
B
Wang
Young Y
YY
Meng
Xiao-Ying
XY
Berchuck
Andrew
A
Van Haaften-Day
Carolien
C
Hacker
Neville F
NF
de Bruijn
Henk W A
HW
van der Zee
Ate G J
AG
Jacobs
Ian J
IJ
Fung
Eric T
ET
Chan
Daniel W
DW
D000595:Amino Acid Sequence; D016632:Apolipoprotein A-I / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D006801:Humans; D007118:Immunoassay; D008875:Middle Aged; D008969:Molecular Sequence Data; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D011228:Prealbumin / Q000378:metabolism; D011237:Predictive Value of Tests; D040081:Protein Array Analysis; D040901:Proteomics / Q000379:methods*; D012189:Retrospective Studies
D016632:Apolipoprotein A-I; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D011228:Prealbumin