Combination of serum biomarkers to differentiate malignant from benign ovarian tumours.
OBJECTIVE
To investigate biomarkers and clinical parameters to distinguish ovarian cancers from benign ovarian tumours.


METHODS
Serum biomarkers (CA 125, human epididymis protein 4 [HE 4], interleukin-18 [IL-18], leptin, macrophage migration inhibitory factor [MIF], fibroblast growth factor 2 [FGF-2], insulin-like growth factor, osteopontin, prolactin) and the risk of malignancy indexes I and II (RMI-I and RMI-II) scores were obtained prior to surgery in 52 patients with ovarian tumours (37 malignant and 15 benign). ROC curves were built for each individual marker, for logistic regression models using all markers, and for models combining both biomarkers and RMI scores.


RESULTS
The model with nine biomarkers performed well (specificity 93%, sensitivity 84%) and was more reliable than the RMI-I or RMI-II alone. A regression model combining RMI-II and six of the biomarkers (CA 125, HE  4, IL-18, leptin, MIF, and FGF-2) allowed differentiation between the cancer and non-cancer cases in this pilot study.


CONCLUSIONS
The regression models using biomarkers combined with clinical scoring systems warrant further investigation to improve triage of patients with ovarian tumours to enhance utilization of resources and optimize patient care.
Department of Diagnostic Medicine, Jewish General Hospital, McGill University, Montreal QC.
Gang
G
He
Centre for Clinical Epidemiology, Jewish General Hospital, McGill University, Montreal QC.
Christina A
CA
Holcroft
Lady Davis Institute for Medical Research, Montreal QC.
Marie-Claude
MC
Beauchamp
Lady Davis Institute for Medical Research, Montreal QC.
Amber
A
Yasmeen
Department of Pathology, Jewish General Hospital, McGill University, Montreal QC.
Alex
A
Ferenczy
Centre de recherche du Centre hospitalier de l'Université de Montréal/Institut du Cancer de Montréal, Université de Montréal, Montreal QC.
Jennifer
J
Kendall-Dupont
Centre de recherche du Centre hospitalier de l'Université de Montréal/Institut du Cancer de Montréal, Université de Montréal, Montreal QC; Département de médicine, Université de Montréal, Montreal QC.
Anne-Marie
AM
Mes-Masson
Centre de recherche du Centre hospitalier de l'Université de Montréal/Institut du Cancer de Montréal, Université de Montréal, Montreal QC; Division de gynécologie oncologique, Université de Montréal, Montreal QC.
Diane
D
Provencher
Lady Davis Institute for Medical Research, Montreal QC; Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal QC.
Walter H
WH
Gotlieb
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000097:blood; D006801:Humans; D020382:Interleukin-18 / Q000097:blood; D020738:Leptin / Q000097:blood; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood; D008875:Middle Aged; D053495:Osteopontin / Q000097:blood; D010051:Ovarian Neoplasms / Q000097:blood* / Q000473:pathology*; D011388:Prolactin / Q000097:blood; D011506:Proteins / Q000378:metabolism; D012372:ROC Curve; D013002:Somatomedins / Q000378:metabolism; D000081102:WAP Four-Disulfide Core Domain Protein 2; D055815:Young Adult
D015415:Biomarkers; D018394:CA-125 Antigen; D020382:Interleukin-18; D020738:Leptin; D008263:Macrophage Migration-Inhibitory Factors; D011506:Proteins; D013002:Somatomedins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human; D016222:Fibroblast Growth Factor 2; D053495:Osteopontin; D011388:Prolactin