title: B7-h4 is a novel membrane-bound protein and a candidate serum and tissue biomarker for ovarian cancer.
abstract: Using cDNA database mining strategies and real-time quantitative reverse transcription-PCR, we identified B7-H4 as a novel gene that is overexpressed in ovarian and breast cancer tissues when compared with normal tissues. The gene encodes a protein of 282 amino acids with a signal sequence, an immunoglobulin domain, and a COOH-terminal hydrophobic transmembrane domain. Immunohistochemistry experiments show plasma membrane staining in serous ovarian and breast cancer, confirming the tissue specificity and cell surface localization. We have developed a sensitive dual monoclonal antibody sandwich ELISA to analyze the level of B7-H4 protein in >2,500 serum samples, ascites fluids, and tissue lysates. High levels of B7-H4 protein were detected in ovarian cancer tissue lysates when compared with normal tissues. B7-H4 was present at low levels in all sera but showed an elevated level in serum samples from ovarian cancer patients when compared with healthy controls or women with benign gynecologic diseases. The median B7-H4 concentration in endometrioid and serous histotypes was higher than in mucinous histotypes, consistent with results of immunohistochemical staining. The multivariate logistic regression analysis of B7-H4 and CA125 measured in the same sample set resulted in an area under the curve (AUC) of 0.86 for all stages and 0.86 for stage I/II patients, which was significantly higher than the AUC for either marker alone. In early-stage patients, the sensitivity at 97% specificity increased from 52% for CA125 alone to 65% when used in combination with B7-H4. We conclude that B7-H4 is a promising new biomarker for ovarian carcinoma.
authors.affiliation: diaDexus Inc., 343 Oyster Point Boulevard, South San Francisco, CA 94080, USA. isimon@diadexus.com
authors.forename: Iris
authors.initials: I
authors.lastname: Simon
authors.forename: Shaoqiu
authors.initials: S
authors.lastname: Zhuo
authors.forename: Laura
authors.initials: L
authors.lastname: Corral
authors.forename: Eleftherios P
authors.initials: EP
authors.lastname: Diamandis
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Sarno
authors.forename: Robert L
authors.initials: RL
authors.lastname: Wolfert
authors.forename: Nam W
authors.initials: NW
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000378:metabolism; D018122:B7-1 Antigen / Q000097:blood / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism*; D015153:Blotting, Western; D018394:CA-125 Antigen / Q000097:blood / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008593:Menopause / Q000097:blood; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000378:metabolism*; D012680:Sensitivity and Specificity; D060907:V-Set Domain-Containing T-Cell Activation Inhibitor 1
chemical_list: D018122:B7-1 Antigen; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D060907:V-Set Domain-Containing T-Cell Activation Inhibitor 1; C475826:VTCN1 protein, human