CA125, YKL-40, HE-4 and Mesothelin: a new serum biomarker combination in discrimination of benign and malign epithelial ovarian tumor

2019 ◽  
Vol 44 (4) ◽  
pp. 438-451
Author(s):  
Banu Deveci ◽  
Belgin Sert Serdar ◽  
Pınar Karabacakoğlu Kemik ◽  
Hatice Şimşek Keskin ◽  
Nuri Yildirim ◽  
...  
Keyword(s):  
Ovarian Tumor ◽  
Diagnostic Performance ◽  
Menopausal Status ◽  
Study Groups ◽  
Cancer Antigen 125 ◽  
Epithelial Ovarian Tumor ◽  
Preoperative Stage ◽  
Benign Ovarian Tumor ◽  
Tumor Stages ◽  
Gdp Dissociation Inhibitor

Abstract Objective Cancer Antigen 125 (CA125) and Risk of Ovarian Malignancy Algorithm (ROMA) score are used for classification of ovarian masses (benign/malign) in preoperative stage. However, their discrimination capacity are considered insufficient, and greatly effected by histological subtype and menopausal status. This study aimed to investigate diagnostic performance of Human epididymis protein 4 (HE4), Y (tyrosine), K (lysine), and L (leucine)-40 (YKL-40), Mesothelin, Rho GDP dissociation inhibitor ß (LyGDI), CA125 or their combinations in discrimination of benign/malign ovarian diseases in preoperative stage. Materials and methods The study groups were comprised sera of 31 epithelial ovarian cancer (EOC), 30 benign ovarian tumor patients, and 32 healthy women. The diagnostic performance of the biomarkers were evaluated based on ROC-AUC values and logistic regression analysis incorporating menopausal status and clinical diagnosis of the subjects. Results Our data demonstrates that “CA125-HE4-Mesothelin-YKL-40” had the highest sensitivity at 80%, 90%, 95% specificity 96.8%, 93.6%, 93.6%, respectively. Conclusion This study provides the first evidence for the combinational uses of “CA125-HE4-Mesothelin-YKL-40” as a panel in distinguishing malign from benign ovarian tumor, not affected by menopausal status unlike ROMA. However, higher patient number may also provide the evaluation of this panel in malign group in terms of tumor stages.

scholarly journals Diagnostic extended usefulness of RMI: comparison of four risk of malignancy index in preoperative differentiation of borderline ovarian tumors and benign ovarian tumors

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Shuang Zhang ◽  
Shan Yu ◽  
Wenying Hou ◽  
Xiaoying Li ◽  
Chunping Ning ◽  
...  
Keyword(s):  
Ovarian Tumor ◽  
Menopausal Status ◽  
Area Under The Curve ◽  
Ovarian Tumors ◽  
Borderline Ovarian Tumor ◽  
Cancer Antigen 125 ◽  
Borderline Ovarian Tumors ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Benign Ovarian Tumors

Abstract Background This study aimed to examine the performance of the four risk of malignancy index (RMI) in discriminating borderline ovarian tumors (BOTs) and benign ovarian masses in daily clinical practice. Methods A total of 162 women with BOTs and 379 women with benign ovarian tumors diagnosed at the Second Affiliated Hospital of Harbin Medical University from January 2012 to December 2016 were enrolled in this retrospective study. Also, we classified these patients into serous borderline ovarian tumor (SBOT) and mucinous borderline ovarian tumor (MBOT) subgroup. Preoperative ultrasound findings, cancer antigen 125 (CA125) and menopausal status were reviewed. The area under the curve (AUC) of receiver operator characteristic curves (ROC) and performance indices of RMI I, RMI II, RMI III and RMI IV were calculated and compared for discrimination between benign ovarian tumors and BOTs. Results RMI I had the highest AUC (0.825, 95% CI: 0.790–0.856) among the four RMIs in BOTs group. Similar results were found in SBOT (0.839, 95% CI: 0.804–0.871) and MBOT (0.791, 95% CI: 0.749–0.829) subgroups. RMI I had the highest specificity among the BOTs group (87.6, 95% CI: 83.9–90.7%), SBOT (87.6, 95% CI: 83.9–90.7%) and MBOT group (87.6, 95% CI: 83.9–90.7%). RMI II scored the highest overall in terms of sensitivity among the BOTs group (69.75, 95% CI: 62.1–76.7%), SBOT (74.34, 95% CI: 65.3–82.1%) and MBOT (59.18, 95% CI: 44.2–73.0%) group. Conclusion Compared to other RMIs, RMI I was the best-performed method for differentiation of BOTs from benign ovarian tumors. At the same time, RMI I also performed best in the discrimination SBOT from benign ovarian tumors.

scholarly journals Risk of malignancy index 4 in preoperative evaluation of patients with ovarian tumours

2018 ◽  
Vol 7 (6) ◽  
pp. 2467
Author(s):  
Sunita Singhal ◽  
Lata Rajoria ◽  
Premlata Mital ◽  
Alka Batar ◽  
Richa Ainani ◽  
...  
Keyword(s):  
Predictive Value ◽  
Ovarian Tumor ◽  
Preoperative Evaluation ◽  
Menopausal Status ◽  
Ovarian Tumour ◽  
Ca 125 ◽  
Benign Ovarian Tumor ◽  
Ovarian Tumours ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Background: Ovarian tumors usually presents as adnexal masses which may be benign or malignant. Accurate and timely diagnosis of an adnexal mass is a challenge for the gynecologists. Currently clinical examination, ultrasonographic assessment and ovarian tumour markers (CA 125, beta hCG, AFP, LDH) are routinely done at our centre to evaluate patients with ovarian tumours. The study was designed to evaluate the ability of RMI 4 to discriminate benign ovarian tumor from malignant ovarian tumor in patients attending Department of Obstetrics and Gynaecology, S.M.S. Medical College, Jaipur.Methods: 200 patients diagnosed to have ovarian tumours were included in the study after obtaining written consent. Ultrasonographic characteristic, menopausal status and serum CA 125 levels were documented preoperatively. Risk of malignancy index 4 was calculated and correlated with histopathological diagnosis.Results: At a cut-off point of 450, RMI 4 had a sensitivity of 67.5% (95% CI: 50.87-81.43%), specificity of 98.75% (95.56-99.85%), positive likelyhood ratio of 54, negative likelyhood ratio of 0.33, a positive predictive value of 93.1%, negative predictive value of 92.4% and diagnostic accuracy of 92.5%.Conclusions: RMI 4 is a simple, cost effective, reliable scoring system that is easily applicable method in primary evaluation of patients with ovarian tumours with a sensitivity of 67.5% and specificity of 98.75%.

scholarly journals CPH-I and HE4 Are More Favorable Than CA125 in Differentiating Borderline Ovarian Tumors from Epithelial Ovarian Cancer at Early Stages

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Zhiheng Wang ◽  
Xiang Tao ◽  
Chunmei Ying
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Menopausal Status ◽  
Ovarian Tumors ◽  
Cancer Antigen 125 ◽  
Borderline Ovarian Tumors ◽  
Early Stages ◽  
Pathological Subtype ◽  
Benign Ovarian Tumor ◽  
Significant Difference

Aim. To evaluate the diagnosis value of serum human epididymis protein 4 (HE4), cancer antigen 125 (CA125), the Risk of Ovarian Malignancy Algorithm (ROMA), and Copenhagen Index (CPH-I) at early stages for differentiating borderline ovarian tumors from epithelial ovarian cancer. Methods. We recruited 144 borderline ovarian tumors in FIGO stages I and II (BOT I+II), 108 epithelial ovarian cancers in FIGO stages I and II (EOC I+II), and 238 benign ovarian tumor patients with surgical treatment in the retrospective study. The concentration of HE4 and CA125 and the values of CPH-I and ROMA were assessed separately. Results. The HE4 level and ROMA and CPH-I values of EOC I+II were all higher than that of BOT I+II and benign groups whether in all, pre-, or postmenopausal groups (P<0.01). When distinguishing BOT I+II from EOC I+II, the AUC-ROC of CPH-I and HE4 were bigger than CA125 (P<0.001), while the CPH-I has the highest sensitivities in all and postmenopausal groups (78.7%, 85.1%), and HE4 has the highest specificity and PPV (90.91%, 88.64%) in postmenopausal groups. Under pathological stratification, HE4, ROMA, and CPH-I of the serous EOC I+II were higher than that of BOT I+II (P<0.001) and the AUC of the three indices were significantly bigger than CA125 (P<0.001). However, the concentration of HE4 and CA125 and the values of CPH-I and ROMA have no significant difference between the two endometrioid subgroups. The index with the highest sensitivity and NPV among the four indices of different pathological subtype groups was CPH-I, and the index with the highest specificities and PPV was HE4. Conclusion. CPH-I was more valuable than CA125 for differentiating BOT I+II from EOC I+II regardless of menopausal status, while HE4 might be better than CA125 for postmenopausal subgroups. HE4 and CPH-I were more favorable than CA125 for differentiating BOT I+II from EOC I+II in the case of unknown pathology or in serous type.

scholarly journals BARD1 Autoantibody Blood Test for Early Detection of Ovarian Cancer

Genes ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 969
Author(s):  
Maxim Pilyugin ◽  
Magda Ratasjka ◽  
Maciej Stukan ◽  
Nicole Concin ◽  
Robert Zeillinger ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Early Detection ◽  
Blood Test ◽  
Menopausal Status ◽  
Clinical Samples ◽  
Average Risk ◽  
Healthy Controls ◽  
Cancer Antigen 125 ◽  
Cancer Syndrome ◽  
Ovarian Cancer Screening

Background: Ovarian cancer (OC) is the most lethal gynaecological cancer. It is often diagnosed at an advanced stage with poor chances for successful treatment. An accurate blood test for the early detection of OC could reduce the mortality of this disease. Methods: Autoantibody reactivity to 20 epitopes of BARD1 and concentration of cancer antigen 125 (CA125) were assessed in 480 serum samples of OC patients and healthy controls. Autoantibody reactivity and CA125 were also tested for 261 plasma samples of OC with or without mutations in BRCA1/2, BARD1, or other predisposing genes, and healthy controls. Lasso statistic regression was applied to measurements to develop an algorithm for discrimination between OC and controls. Findings and interpretation: Measurement of autoantibody binding to a number of BARD1 epitopes combined with CA125 could distinguish OC from healthy controls with high accuracy. This BARD1-CA125 test was more accurate than measurements of BARD1 autoantibody or CA125 alone for all OC stages and menopausal status. A BARD1-CA125-based test is expected to work equally well for average-risk women and high-risk women with hereditary breast and ovarian cancer syndrome (HBOC). Although these results are promising, further data on well-characterised clinical samples shall be used to confirm the potential of the BARD1-CA125 test for ovarian cancer screening.

Serum SELDI-TOF MS analysis model applied to benign and malignant ovarian tumor identification

2016 ◽  
Vol 8 (1) ◽  
pp. 183-188 ◽  
Author(s):  
Yankun Li ◽  
Xiangchao Zeng
Keyword(s):  
Ovarian Tumor ◽  
Analysis Model ◽  
Pattern Recognition Technique ◽  
Serum Peptide ◽  
Tumor Identification ◽  
Benign Ovarian Tumor ◽  
Malignant Ovarian Tumor ◽  
Peptide Profiles ◽  
Recognition Technique ◽  
Tof Ms

SELDI-TOF MS serum peptide profiles of malignant and benign ovarian tumor samples were studied using a pattern recognition technique.

scholarly journals Meigs' syndrome with elevated CA 125: case report

2003 ◽  
Vol 121 (5) ◽  
pp. 210-212 ◽  
Author(s):  
Sabas Carlos Vieira ◽  
Leonardo Halley Carvalho Pimentel ◽  
José Carlos Castelo Branco Ribeiro ◽  
Argemiro Ferreira de Andrade Neto ◽  
Jerúsia Oliveira Ibiapina de Santana
Keyword(s):  
Case Report ◽  
Pleural Effusion ◽  
Ovarian Tumor ◽  
Frozen Section ◽  
Transvaginal Ultrasound ◽  
Elevated Serum ◽  
Ca 125 ◽  
Brazilian Woman ◽  
Thoracic Drainage ◽  
Benign Ovarian Tumor

CONTEXT: Meigs' syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum CA 125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs' syndrome can also have elevated serum CA 125 levels. The authors report a case of Meigs' syndrome with elevated CA 125 level. OBJECTIVE: This is a case report of Meigs' syndrome with elevated CA 125 level. CASE REPORT: A 65-year-old Brazilian woman had presented progressive dyspnea, weight loss and decline in general condition over the 7 months preceding admission to our service. In another hospital, the patient had been submitted to thoracic drainage due to pleural effusion. With recurrence of the pleural effusion and increase in abdominal volume due to ascites and a pelvic mass, the patient sought our service. Transvaginal ultrasound showed an extensive adnexal solid mass of 16.4 x 10.8 cm located in the pelvis without exact limits, and the serum CA 125 level was elevated. With a preoperative diagnosis of ovarian carcinoma, the patient was submitted to exploratory laparotomy, which revealed a left ovarian tumor. The frozen section diagnosis was thecoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The histology of the specimen confirmed the diagnosis of thecoma. The patient was asymptomatic with a normal serum CA 125 level 20 months after the operation.

scholarly journals LARGE BENIGN OVARIAN TUMOR MIMICKING LATE STAGE MALIGNANT OVARIAN TUMOR

2021 ◽  
Vol 9 (02) ◽  
pp. 848-852
Author(s):  
M. Bendahhou Idrissi ◽  
◽  
K. Aboulfath ◽  
S. Errarhay ◽  
N. Mamouni ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Ovarian Tumor ◽  
Benign Neoplasm ◽  
Exploratory Laparotomy ◽  
Point Of View ◽  
Pathological Examination ◽  
Multiple Biopsies ◽  
Benign Ovarian Tumor ◽  
Peritoneal Effusion ◽  
Fear Of Cancer

Ovarian fibrothecoma is a rare, benign neoplasm of the sex cords and stroma of the ovary. Patients may present with abdominal pelvic pain and / or distension, and sometimes postmenopausal bleeding. Large tumors (> 10cm) are often associated with pleural and peritoneal effusion mimicking an advanced ovarian malignancy (Deimon –Meigs syndrome). We report 2 cases of giant fibrothecoma associated with ascites and pleurisy. Both patients were postmenopausal. The ovarian tumor was discovered during an increase in abdominal volume in the first patient and as part of the etiological workup of encysted pleurisy in the second. The clinical examination made it possible to objectify a tumor with abdominopelvic development of size greater than 10 cm, the clinical examination also noted, in the two patients, a right basithoracic dullness in favor of a pleurisy and an ascites of average abundance suggesting in the first place a malignant tumor of the ovary, with peritoneal carcinoma. the two patients underwent a pelvic ultrasound, supplemented by an abdominal pelvic CT scan objectifying the presence of a large ovarian mass with pleural and peritoneal effusions. Exploratory laparotomy was required in both patients and underwent an extemporaneous examination which was consistent with the definitive pathological examination in both patients. Both patients underwent total hysterectomy with bilateral adnexectomy and omentectomy with multiple biopsies as the clinical picture was highly suggestive of malignancy. The postoperative follow-up was simple with total regression of peritoneal and pleural effusions in the two cases of Demons-Meigs syndrome. The definitive pathological examination revealed a fibrothecoma. Fibrothecal tumors remain a real challenge from a diagnostic and therapeutic point of view. The fear of cancer is even greater in the presence of Demons-Meigs syndrome. The management of these tumors requires a good clinical and radiological analysis, and it is the histological examination that confirms the diagnosis. The surgery corresponds, in post-menopausal patients, to a hysterectomy with bilateral adnexectomy, while conservative treatment by unilateral adnexectomy is entirely justified in young women who still want fertility.

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