Blyuss Oleg, Gentry-Maharaj Alex, Fourkala Evangelia-Orania, Ryan Andy, Zaikin Alexey, Menon Usha, Jacobs Ian, Timms John F
Women's Cancer, Institute for Women's Health, University College London, Gower Street, London WC1E 6BT, UK.
Women's Cancer, Institute for Women's Health, University College London, Gower Street, London WC1E 6BT, UK; University of New South Wales, Sydney, NSW 2052, Australia.
Biomed Res Int. 2015;2015:681416. doi: 10.1155/2015/681416. Epub 2015 Dec 24.
Early detection of ovarian cancer through screening may have impact on mortality from the disease. Approaches based on CA125 cut-off have not been effective. Longitudinal algorithms such as the Risk of Ovarian Cancer Algorithm (ROCA) to interpret CA125 have been shown to have higher sensitivity and specificity than a single cut-off. The aim of this study was to investigate whether other ovarian cancer-related biomarkers, Human Epididymis 4 (HE4), glycodelin, mesothelin, matrix metalloproteinase 7 (MMP7), and cytokeratin 19 fragment (CYFRA 21-1), could improve the performance of CA125 in detecting ovarian cancer earlier. Serum samples (single and serial) predating diagnosis from 47 women taking part in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) who went on to develop primary invasive ovarian, fallopian tube, or peritoneal cancer (index cancer) (170 samples) and 179 matched controls (893 samples) were included in the study. A multiplex immunobased assay platform (Becton Dickinson) allowing simultaneous measurement of the six serum markers was used. The area under the ROC curve for the panel of three biomarkers (CA125, HE4, and glycodelin) was higher than for CA125 alone for all analysed time groups, indicating that these markers can improve on sensitivity of CA125 alone for ovarian cancer detection.
通过筛查早期发现卵巢癌可能会对该疾病的死亡率产生影响。基于CA125临界值的方法并不有效。纵向算法，如卵巢癌风险算法（ROCA）用于解读CA125，已显示出比单一临界值具有更高的敏感性和特异性。本研究的目的是调查其他与卵巢癌相关的生物标志物，人附睾蛋白4（HE4）、糖蛋白1、间皮素、基质金属蛋白酶7（MMP7）和细胞角蛋白19片段（CYFRA 21-1），是否能在更早检测卵巢癌方面提高CA125的性能。研究纳入了47名参与英国卵巢癌筛查协作试验（UKCTOCS）的女性在诊断前的血清样本（单次和系列样本），这些女性后来发展为原发性浸润性卵巢癌、输卵管癌或腹膜癌（索引癌）（170个样本）以及179名匹配对照（893个样本）。使用了一个基于多重免疫分析的检测平台（贝克曼库尔特），可同时测量这六种血清标志物。对于所有分析的时间组，三种生物标志物（CA125、HE4和糖蛋白1）组合的ROC曲线下面积高于单独的CA125，这表明这些标志物可以提高CA125单独检测卵巢癌的敏感性。
