The ROMA (Risk of Ovarian Malignancy Algorithm) for estimating the risk of epithelial ovarian cancer in women presenting with pelvic mass: is it really useful?

The purpose of the current study was to clarify differences in microRNA expression according to clinicopathological characteristics, and to investigate if miRNA profiles could predict cytoreductive outcome in patients with FIGO stage IIIC and IV ovarian cancer. Patients enrolled in the Pelvic Mass study between 2004 and 2010, diagnosed and surgically treated for epithelial ovarian cancer, were used for investigation. MicroRNA was profiled from tumour tissue with global microRNA microarray analysis. Differences in miRNA expression profiles were analysed according to histologic subtype, FIGO stage, tumour grade, type I or II tumours and result of primary cytoreductive surgery. One microRNA, miR-130a, which was found to be associated with serous histology and advanced FIGO stage, was also validated using data from external cohorts. Another seven microRNAs (miR-34a, miR-455-3p, miR-595, miR-1301, miR-146-5p, 193a-5p, miR-939) were found to be significantly associated with the clinicopathological characteristics (p ≤ 0.001), in our data, but mere not similarly significant when tested against external cohorts. Further validation in comparable cohorts, with microRNA profiled using newest and similar methods are warranted.

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One-Stop Clinic for Patients with Suspected Ovarian Cancer Pathway from a Retrospective Outcome Study

10.21203/rs.3.rs-42449/v1 ◽

2020 ◽

Author(s):

Ayisha Adeeba Ashmore ◽

C. Gnanachandran ◽

I. Luqman ◽

K. Horrocks

Keyword(s):

Ovarian Cancer ◽

Primary Care ◽

Pelvic Mass ◽

Initial Assessment ◽

Ca 125 ◽

Outcome Study ◽

Ovarian Malignancy ◽

Cancer Symptoms ◽

Nice Guideline ◽

One Stop

Abstract Background:Recent encouragement in early detection of cancer nationally has significantly increased the number of referrals made through the two-week wait suspected cancer pathway. In particular women with abdominal pain and bloating are frequently having their Ca-125 levels investigated for suspected ovarian cancer and this has led to a significant increase in referrals to the ovarian cancer service. We have conducted this study to help improve the efficiency in which these patients are investigated and to improve future pathways within the referral service. Methods:A retrospective observational outcome study. Data were collected from electronic documents of patients’ referrals, assessments, and clinical correspondences.The study was conducted in a tertiary gynaecology cancer centre with primary care direct referrals. The pelvic mass clinic was the clinic setup with consultation, scan and patient support was available. All patients referred by direct primary care for suspected ovarian cancer over two years with Ca-125 result. Data were collected and analysed from the pelvic mass clinic over 48 months, which was available through electronic documentation. Data included information on their consultation, ultrasound scan findings, any further intervention, surgery, and histological outcome of all patient who underwent biopsies or surgery.Results: Two hundred and eighty-six patients were referred from primary care where the NICE guideline, ‘two-week wait for ovarian cancer’, was applied. Two hundred and twenty-three patients were included in this analysis, who had a Ca-125 result reported at the time of their referral. Out of the 223 patients, 126 patients were discharged with or without a repeat Ca-125 after the initial assessment. Seventeen patients were diagnosed with cancer following the referral, but only 12 of them had a primary ovarian malignancy. Conclusion:Majority of the patients with Ca-125 of more than 35U/mL, who were referred through this pathway, did not have cancer. This message can be disseminated by primary care practitioners who may be able to reassure patients prior to their initial consultation with a gynaecologist. This review queries the future value of using Ca-125 as the basis for referrals from primary care referrals for suspected ovarian malignancy. Further studies are required to assess whether a higher Ca-125 cut off may be used as the basis of referrals for postmenopausal women. One-stop focused gynaecology ultrasound clinic (OSFGUC) where clinicians may assess patients with suspected ovarian cancer symptoms and perform ultrasound scans may be better for managing this patient population.

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Discovery and Validation of Novel Biomarkers for Detection of Epithelial Ovarian Cancer

Cells ◽

10.3390/cells8070713 ◽

2019 ◽

Vol 8 (7) ◽

pp. 713 ◽

Cited By ~ 7

Author(s):

Kulbe ◽

Otto ◽

Darb-Esfahani ◽

Lammert ◽

Abobaker ◽

...

Keyword(s):

Gene Expression ◽

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Biomarker Discovery ◽

Expression Profiles ◽

Gene Expression Profiles ◽

Pelvic Mass ◽

Aurora Kinase ◽

Malignant Tumours ◽

Novel Biomarkers

Detection of epithelial ovarian cancer (EOC) poses a critical medical challenge. However, novel biomarkers for diagnosis remain to be discovered. Therefore, innovative approaches are of the utmost importance for patient outcome. Here, we present a concept for blood-based biomarker discovery, investigating both epithelial and specifically stromal compartments, which have been neglected in search for novel candidates. We queried gene expression profiles of EOC including microdissected epithelium and adjacent stroma from benign and malignant tumours. Genes significantly differentially expressed within either the epithelial or the stromal compartments were retrieved. The expression of genes whose products are secreted yet absent in the blood of healthy donors were validated in tissue and blood from patients with pelvic mass by NanoString analysis. Results were confirmed by the comprehensive gene expression database, CSIOVDB (Ovarian cancer database of Cancer Science Institute Singapore). The top 25% of candidate genes were explored for their biomarker potential, and twelve were able to discriminate between benign and malignant tumours on transcript levels (p < 0.05). Among them T-cell differentiation protein myelin and lymphocyte (MAL), aurora kinase A (AURKA), stroma-derived candidates versican (VCAN), and syndecan-3 (SDC), which performed significantly better than the recently reported biomarker fibroblast growth factor 18 (FGF18) to discern malignant from benign conditions. Furthermore, elevated MAL and AURKA expression levels correlated significantly with a poor prognosis. We identified promising novel candidates and found the stroma of EOC to be a suitable compartment for biomarker discovery.

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Multiple biomarker algorithms to predict epithelial ovarian cancer in women with a pelvic mass: Can additional makers improve performance?

Gynecologic Oncology ◽

10.1016/j.ygyno.2019.04.006 ◽

2019 ◽

Vol 154 (1) ◽

pp. 150-155 ◽

Cited By ~ 9

Author(s):

Richard G. Moore ◽

Alexandra Blackman ◽

M. Craig Miller ◽

Katina Robison ◽

Paul A. DiSilvestro ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Pelvic Mass ◽

Improve Performance

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Clinical value of human epididymis protein 4 and the Risk of Ovarian Malignancy Algorithm in differentiating borderline pelvic tumors from epithelial ovarian cancer in early stages

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2015.09.008 ◽

2015 ◽

Vol 194 ◽

pp. 141-146 ◽

Cited By ~ 6

Author(s):

Beata Kotowicz ◽

Malgorzata Fuksiewicz ◽

Piotr Sobiczewski ◽

Beata Spiewankiewicz ◽

Joanna Jonska-Gmyrek ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Ovarian Malignancy ◽

Clinical Value ◽

Human Epididymis Protein 4 ◽

Human Epididymis ◽

Early Stages ◽

Pelvic Tumors

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DIAGNOSTIC VALUE OF CA-125 IN PATIENTS WITH EPITHELIAL OVARIAN CANCER AT THE DR. SOETOMO GENERAL HOSPITAL SURABAYA IN 2016

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v25i2.1380 ◽

2019 ◽

Vol 25 (2) ◽

pp. 145

Author(s):

Kintan Putri ◽

Betty Agustina Tambunan ◽

Willy Sandhika

Keyword(s):

Ovarian Cancer ◽

Positive Predictive Value ◽

Epithelial Ovarian Cancer ◽

Tumor Marker ◽

General Hospital ◽

Negative Predictive Value ◽

Predictive Value ◽

Diagnostic Value ◽

Ca 125 ◽

Ovarian Malignancy

Ovarian cancer is the fourth cancer with most incidence in Indonesian female with 10.238 cases in 20141. Tumor marker CA-125 is assosciated with ovarian cancer, importantly epithelial ovarian cancer. This study aims to find out diagnostic value (sensitivity, specificity, positive predictive value, negative predictive value) of CA-125 among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016. This study used analytic cross sectional method and was performed by evaluating medical records of patients suspected for ovarian malignancy in Dr. Soetomo General Hospital Surabaya in 2016. There were total 97 patients found fit for criteria of inclusion in this study. Tissue histopathological examination confirmed 66 patients have epithelial ovarian malignancy and 31 patients do not. Samples distributed using 35 U/ml as CA-125 upper limit, TP: 54.64%, FP: 19.59%, FN: 13.40%, dan TN: 12.37%. Diagnostic value obtained as follows: sensitivity 80.30%, spesificity 38.71%, positive predictive value 73.61%, negative predictive value 48%, and accuracy 67.01%. Tumor marker associated with ovarian cancer CA-125 has found high in sensitivity but low in specificity among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016.

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