title: Clinical significance of osteopontin expression in cervical cancer.
abstract: OBJECTIVE
  New diagnostic markers, other than squamous cell carcinoma (SCC) antigen, are needed for the detection of cervical cancer. Osteopontin (OPN) is a candidate frequently associated with several human malignancies. The purpose of this study was to evaluate the clinical significance of OPN expression as a diagnostic and prognostic biomarker for cervical cancer.
  
  
  METHODS
  Immunohistochemical staining of tissue from 97 cervical cancer cases and 22 healthy subjects was performed in order to determine the source of elevated plasma OPN levels. In addition, plasma OPN levels of 81 patients with cervical cancer, 34 patients with carcinoma in situ (CIS) of the uterine cervix, and those of 283 healthy women were measured with a commercially available solid-phase sandwich enzyme-linked immunosorbent assay (ELISA). The correlation between OPN levels and clinical features were examined and compared to SCC antigen levels in the cervical cancer cases.
  
  
  RESULTS
  Immunohistochemical staining revealed OPN immunoreactivity in 67.0% (65/97) of cervical cancer tissues, and the immunostaining score in the cervical cancer tissue sections was 2.06 (95% CI, 1.70-2.42). There was no significant difference in immunostaining scores based on age, tumor size, and tumor stage, but higher scores (3.0< score <or=6.0) were significantly correlated with overall survival (P = 0.002) and disease-free survival (P = 0.033). Plasma OPN levels in women with cervical cancer (mean 355.8 ng/ml) were significantly higher (P < 0.001) than those of women with CIS (mean: 185 ng/ml) and healthy controls (mean 100 ng/ml). Within the cervical cancer patients, OPN levels correlated with increasing tumor size (P = 0.008) and tumor stage (P < 0.001). The sensitivity and specificity of OPN in detecting cervical cancer was 50.6 and 95.0%, respectively (cutoff value 215.5 ng/ml). Using a combination of markers proved to bring more sensitive results than using one marker (sensitivity: 65.4%, specificity: 90.9%). High plasma OPN levels (>215.5 ng/ml) were also correlated with disease-free survival (P = 0.038).
  
  
  CONCLUSIONS
  These results suggest that plasma OPN levels are potentially useful as a diagnostic and prognostic biomarker for cervical cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-Dong Gangnam-Gu, Seoul, 135-720, South Korea.
authors.forename: HanByoul
authors.initials: H
authors.lastname: Cho
authors.forename: Soon Won
authors.initials: SW
authors.lastname: Hong
authors.forename: Youn Jin
authors.initials: YJ
authors.lastname: Oh
authors.forename: Min A
authors.initials: MA
authors.lastname: Kim
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Kang
authors.forename: Jong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Sang Wun
authors.initials: SW
authors.lastname: Kim
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Kook
authors.initials: K
authors.lastname: Lee
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D018572:Disease-Free Survival; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D053495:Osteopontin / Q000096:biosynthesis* / Q000097:blood*; D011379:Prognosis; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000378:metabolism* / Q000401:mortality
chemical_list: D014408:Biomarkers, Tumor; D053495:Osteopontin