title: A Biomarker Panel Increases the Diagnostic Performance for Epithelial Ovarian Cancer Type I and II in Young Women.
abstract: OBJECTIVE
  To assess preoperative blood levels of a biomarker panel in relation to the new classification system of epithelial ovarian cancer (EOC) type I and II.
  
  
  METHODS
  Preoperative plasma levels of B7-family protein homolog 4 (B7-H4), intact and cleaved soluble urokinase plasminogen activator receptor (suPAR), human epididymis protein 4 (HE4) and cancer antigen 125 (CA125) were analyzed in 350 patients with adnexal lesions.
  
  
  RESULTS
  The levels of suPAR(II-III), HE4, CA125 were all higher in EOC II than in EOC I, borderline and benign ovarian tumors. B7-H4 was increased in EOC II compared with benign ovarian tumors. The combination of suPAR(II-III), HE4, CA125 and age in premenopausal women discriminates EOC and borderline tumors from benign tumors to higher accuracy compared to the Risk of Ovarian Malignancy Algorithm (p=0.007).
  
  
  CONCLUSIONS
  The biomarker panel suPAR(II-III), HE4, CA125 and age in premenopausal women improved discrimination of malignant and benign ovarian tumors. The plasma levels of B7-H4 were increased in patients with EOC II compared to those with benign ovarian tumors.
authors.affiliation: Department of Obstetrics & Gynecology, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Pia
authors.initials: P
authors.lastname: Leandersson
authors.affiliation: Department of Obstetrics & Gynecology, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Grigorios
authors.initials: G
authors.lastname: Kalapotharakos
authors.affiliation: Department of Reproductive Medicine, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Emir
authors.initials: E
authors.lastname: Henic
authors.affiliation: Faculty of Engineering, LTH, Lund University, Lund, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Borgfeldt
authors.affiliation: Health Metrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Max
authors.initials: M
authors.lastname: Petzold
authors.affiliation: Finsen Laboratory, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Høyer-Hansen
authors.affiliation: Department of Obstetrics & Gynecology, Skåne University Hospital, Lund University, Lund, Sweden christer.borgfeldt@med.lu.se.
authors.forename: Christer
authors.initials: C
authors.lastname: Borgfeldt
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D000077216:Carcinoma, Ovarian Epithelial; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis* / Q000378:metabolism; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D017697:Premenopause; D011506:Proteins / Q000378:metabolism*; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood*; D060907:V-Set Domain-Containing T-Cell Activation Inhibitor 1 / Q000097:blood*; D000081102:WAP Four-Disulfide Core Domain Protein 2; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins; D011506:Proteins; D060907:V-Set Domain-Containing T-Cell Activation Inhibitor 1; C475826:VTCN1 protein, human; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human; D014568:Urokinase-Type Plasminogen Activator
keywords: B7-H4; CA125; HE4; ROMA; ovarian neoplasm; survival analyses; uPAR