title: The clinical utility of serum anti-Müllerian hormone in the follow-up of ovarian adult-type granulosa cell tumors--A comparative study with inhibin B.
abstract: Ovarian adult-type granulosa cell tumors (AGCTs) require prolonged follow-up, but evidence regarding the optimal follow-up marker is lacking. The objective of our study was to validate the clinical usefulness of serum anti-Müllerian hormone (AMH) and the current marker inhibin B as single and combined markers of AGCTs. We conducted a longitudinal, partially prospective cohort study of 123 premenopausal and postmenopausal AGCT patients with a median follow-up time of 10.5 years (range 0.3-50.0 years). Serum AMH and inhibin B levels were measured from 560 pretreatment and follow-up serum samples by using immunoenzymometric assays. We found that serum AMH and inhibin B levels were significantly elevated in patients with primary or recurrent AGCTs. The levels of both markers positively correlated to tumor size (p < 0.05). AMH and inhibin B performed similarly in receiving operator characteristic analyses; area under the curve (AUC) values were 0.92 [95% confidence interval (CI) 0.88-0.95] for AMH, and 0.94 (95% CI 0.90-0.96) for inhibin B. AMH was highly sensitive (92%) and specific (81%) in detecting a macroscopic AGCT. However, in AUC comparison analyses, the combination of the markers was superior to inhibin B alone. In conclusion, serum AMH is a sensitive and specific marker of AGCT, and either AMH or inhibin B can be monitored during follow-up. However, combining AMH and inhibin B in AGCT patient follow-up improves the detection of recurrent disease.
authors: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.|Department of Pediatrics, University of Helsinki, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
authors: Anniina
authors: A
authors: Färkkilä
authors: Department of Obstetrics and Gynecology, University of Oulu, Oulu University Hospital and Medical Research Center Oulu, Oulu, Finland.
authors: Sanna
authors: S
authors: Koskela
authors: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
authors: Saara
authors: S
authors: Bryk
authors: Department of Clinical Chemistry, University of Helsinki and HUSlab, Helsinki University Central Hospital, Helsinki, Finland.
authors: Henrik
authors: H
authors: Alfthan
authors: Department of Pathology, University of Helsinki and HUSlab, Helsinki University Central Hospital, Helsinki, Finland.
authors: Ralf
authors: R
authors: Bützow
authors: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
authors: Arto
authors: A
authors: Leminen
authors: Department of Obstetrics and Gynecology, University of Oulu, Oulu University Hospital and Medical Research Center Oulu, Oulu, Finland.
authors: Ulla
authors: U
authors: Puistola
authors: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.|Department of Obstetrics and Gynecology, University of Oulu, Oulu University Hospital and Medical Research Center Oulu, Oulu, Finland.
authors: Juha S
authors: JS
authors: Tapanainen
authors: Department of Pediatrics, University of Helsinki, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.|Department of Pediatrics, Washington University School of Medicine, St Louis Children's Hospital, St Louis, MO.
authors: Markku
authors: M
authors: Heikinheimo
authors: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
authors: Mikko
authors: M
authors: Anttonen
authors: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
authors: Leila
authors: L
authors: Unkila-Kallio
mesh_terms: D000328:Adult; D000368:Aged; D054304:Anti-Mullerian Hormone / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006106:Granulosa Cell Tumor / Q000097:blood*; D006801:Humans; D007265:Inhibins / Q000097:blood*; D008137:Longitudinal Studies; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone
keywords: anti-Müllerian hormone; granulosa cell tumor; inhibin B; ovarian cancer; serum marker