Nosov Vladimir, Su Feng, Amneus Malaika, Birrer Michael, Robins Terry, Kotlerman Jenny, Reddy Srinivasa, Farias-Eisner Robin
Department of Obstetrics and Gynecology, UCLA Medical Center, Los Angeles, CA 90095-1740, USA.
Am J Obstet Gynecol. 2009 Jun;200(6):639.e1-5. doi: 10.1016/j.ajog.2008.12.042. Epub 2009 Mar 14.
Ovarian cancer has the highest mortality of all the gynecologic malignancies with most patients diagnosed at late stages. Serum CA-125 is elevated in only half of patients with stages I-II. We identified 3 serum proteins (apolipoprotein A-1, transthyretin, and transferrin) for the detection of ovarian cancer and reported them combined with CA-125 to effectively detect early-stage mucinous tumors. The objectives of this study were to assess the effectiveness of the panel in detection of early-stage serous and endometrioid ovarian cancers.
In all, 358 serum samples (control, benign adnexal masses, and early-stage and late-stage ovarian cancer) were obtained from the National Cancer Institute. The level of each marker was measured. Multiple logistic regression models were built to calculate sensitivity and specificity.
When combined with CA-125, the panel detected early-stage cancer with a sensitivity of 96%. The highest sensitivity was seen for detection of endometrioid subtype of early-stage carcinomas (98%).
A panel of 4 serum biomarkers effectively detected early-stage ovarian cancers with the highest reported overall sensitivity of 96%. Endometrioid tumors were detected at early stages with a sensitivity of 98%. Prospective clinical analysis of the panel is needed to validate it as an effective screening tool for early-stage ovarian cancer.
卵巢癌是所有妇科恶性肿瘤中死亡率最高的，大多数患者在晚期才被诊断出来。血清CA - 125仅在半数I - II期患者中升高。我们鉴定出3种血清蛋白（载脂蛋白A - 1、转甲状腺素蛋白和转铁蛋白）用于检测卵巢癌，并报告将它们与CA - 125联合可有效检测早期黏液性肿瘤。本研究的目的是评估该检测组合在检测早期浆液性和子宫内膜样卵巢癌方面的有效性。
总共从美国国立癌症研究所获取了358份血清样本（对照、良性附件肿块以及早期和晚期卵巢癌样本）。测量了每种标志物的水平。构建了多元逻辑回归模型以计算敏感性和特异性。
与CA - 125联合时，该检测组合检测早期癌症的敏感性为96%。在检测早期癌的子宫内膜样亚型时敏感性最高（98%）。
一组4种血清生物标志物能有效检测早期卵巢癌，报告的总体最高敏感性为96%。子宫内膜样肿瘤在早期检测的敏感性为98%。需要对该检测组合进行前瞻性临床分析，以验证其作为早期卵巢癌有效筛查工具的有效性。
