title: Two-marker combinations for preoperative discrimination of benign and malignant ovarian masses.
abstract: BACKGROUND
  When caring for patients with ovarian neoplasms, correct preoperative discrimination of benign and malignant disease is deemed vital. In this study, we tested serum biomarkers' alone and in combination, to achieve this aim.
  
  
  METHODS
  We measured the concentrations of Cancer Antigen (CA)-125, CA15-3, CA27-29, Carcinoembryonic Antigen (CEA), CA19-9, human chorionic gonadotropin (hCG), Placental Protein (PP)1490, CA72-4, galectin-3, galectin-1 and Human epididymis protein (HE)4 in sera of 133 patients with pelvic masses by ELISA and correlated the results to subsequent histology. We used the area under the curve (AUC) of biomarkers and their combinations and calculated the 95% confidence intervals by using casewise resampling.
  
  
  RESULTS
  The best single biomarkers were CA-125 (sensitivity and AUC) and HE4 (specificity). Combinations with HE4 and CA19-9 improved the predictive power of CA-125. The best discrimination was achieved by the combination of CA-125 and HE4, with an AUC of 0.961.
  
  
  CONCLUSIONS
  A combination of CA-125 with HE4 could facilitate the identification of women at risk for ovarian cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Ludwig Maximilians University, Innenstadt Campus, Munich, Germany.
authors.forename: Maj Kristin
authors.initials: MK
authors.lastname: Freydanck
authors.forename: Ruediger Paul
authors.initials: RP
authors.lastname: Laubender
authors.forename: Brigitte
authors.initials: B
authors.lastname: Rack
authors.forename: Lan
authors.initials: L
authors.lastname: Schuhmacher
authors.forename: Udo
authors.initials: U
authors.lastname: Jeschke
authors.forename: Christoph
authors.initials: C
authors.lastname: Scholz
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis*; D057234:Preoperative Period; D011506:Proteins / Q000032:analysis*; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human