title: Serum HE4, CA125, YKL-40, bcl-2, cathepsin-L and prediction optimal debulking surgery, response to chemotherapy in ovarian cancer.
abstract: BACKGROUND
  The most important prognostic factor in the ovarian cancer is optimal cytoreduction. The neoadjuvant chemotherapy, an only optional method of treatment in this case and is still the subject of debate. The object of this study was to evaluate the usefulness of markers: CA 125, HE4, YKL-40 and bcl-2 as well as cathepsin L in predicting optimal cytoreduction and response to chemotherapy.
  
  
  METHODS
  Sera were secured preoperatively. The division into groups was performed retrospectively depending on the method of treatment (surgery vs neoadjuvant chemotherapy) as well as on response to chemotherapy (sensitive vs resistant vs refractory). Comparisons were made between groups, and the diagnostic usefulness of tested proteins was examined.
  
  
  RESULTS
  We found that statistically significant differences between primary operated patients and patients undergoing neoadjuvant chemotherapy were applicable only to the tumour markers (CA125 1206.79 vs 2432.38, p=0.000191; HE4 78.87 vs 602.45, p=0.000004; YKL-40 108.13 vs 203.96, p=0.003991). Cathepsin-L and Bcl-2 were statistically insignificant. The cut-off point values were determined for the CA 125 (345 mIU/ml), HE4 (218.43 pmol/L) and YKL-40 (140.9 ng/ml). The sensitivity, specificity, PPV and NPV were as follows: CA125 (83.3%; 75%; 80.6%; 78.3%), HE4 (86.6%; 91.3%; 92.9%; 84%) and YKL-40 (75%; 83.3%; 84%; 74.1%).
  
  
  CONCLUSIONS
  Among the tested proteins the HE4 marker appears to be helpful in forecasting of optimal cytoreduction and possibly also of the prediction of response to platinum analogues used in first-line treatment of ovarian cancer.
authors.affiliation: Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Anita Monika
authors.initials: AM
authors.lastname: Chudecka-Głaz
authors.affiliation: Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Aneta Alicja
authors.initials: AA
authors.lastname: Cymbaluk-Płoska
authors.affiliation: Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Janusz Leszek
authors.initials: JL
authors.lastname: Menkiszak
authors.affiliation: Department of Mathematics Applications in Economy, West Pomeranian University of Technology, Szczecin, Poland.
authors.forename: Agnieszka Monika
authors.initials: AM
authors.lastname: Sompolska-Rzechuła
authors.affiliation: International Hereditary Cancer Centre, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Aleksandra Izabela
authors.initials: AI
authors.lastname: Tołoczko-Grabarek
authors.affiliation: Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Izabella Anna
authors.initials: IA
authors.lastname: Rzepka-Górska
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D056668:Cathepsin L / Q000097:blood*; D000071451:Chitinase-3-Like Protein 1; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D037102:Lectins / Q000097:blood*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D057234:Preoperative Period; D011379:Prognosis; D011506:Proteins; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000097:blood*; D012372:ROC Curve; D015203:Reproducibility of Results; D016896:Treatment Outcome; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D054392:Adipokines; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D037102:Lectins; D011506:Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human; D056668:Cathepsin L
keywords: CA125; Cathepsin-L; Debulking surgery; HE4; Neoadjuvant chemotherapy; Ovarian cancer; YKL-40