Future Screening Prospects for Ovarian Cancer

Current diagnostic tools used in clinical practice such as transvaginal ultrasound, CA 125, and HE4 are not sensitive and specific enough to diagnose OC in the early stages. A lack of early symptoms and an effective asymptomatic population screening strategy leads to a poor prognosis in OC. New diagnostic and screening methods are urgently needed for early OC diagnosis. Liquid biopsies have been considered as a new noninvasive and promising method, using plasma/serum, uterine lavage, and urine samples for early cancer detection. We analyzed recent studies on molecular biomarkers with specific emphasis on liquid biopsy methods and diagnostic efficacy for OC through the detection of circulating tumor cells, circulating cell-free DNA, small noncoding RNAs, and tumor-educated platelets.

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Benign Ovarian Cysts with Raised CA-125 Levels: Do We Need to Evaluate the Fallopian Tubes?

Journal of Laboratory Physicians ◽

10.1055/s-0040-1722547 ◽

2020 ◽

Vol 12 (04) ◽

pp. 276-280

Author(s):

Devesh Sharma ◽

Anjali Vinocha

Keyword(s):

Ovarian Cancer ◽

Ovarian Cyst ◽

Transvaginal Ultrasound ◽

Premenopausal Women ◽

Carbohydrate Antigen ◽

Ca 125 ◽

Ovarian Cysts ◽

Fallopian Tubes ◽

Case Record ◽

Carbohydrate Antigen 125

Abstract Objectives It is not clearly known whether some benign (simple) ovarian cysts can convert into cancerous cysts. Size of cyst and wall abnormalities do predict the potentiality of malignancy. Not many studies have been done to explore the malignant potential of large-sized (> 5 cm) unilocular ovarian cysts without wall abnormalities. This study evaluated the correlation between ultrasonographic size of benign ovarian cysts and carbohydrate antigen 125 (CA-125) levels. Methodology Sixty (60) premenopausal women were recruited for the study preoperatively, based on transvaginal ultrasound (TVUS) findings present in the case record sheet received along with the CA-125 sample in the biochemistry laboratories. Those cases with elevated CA-125 levels were selected, where patients had unilocular ovarian cysts without wall abnormalities. CA-125 was done using ECLIA methodology (Cobas e411, Germany). Statistical correlation was calculated between the ovarian cyst size and CA-125 levels using Spearman’s Rho coefficient. Results Mean age group of subjects were 29.7 ± 7.3 years and mean value of CA-125 (normal < 35 IU/mL) was found to be increased: 118.0 ± 147.1 IU/mL so was the mean diameter of cysts (cut off ≤ 5 cm): 48.6 ± 59.8 cm. No correlation was found between CA-125 levels and volume of ovarian cyst (r = 0.005, p = 0.680) for all subjects. Conclusions The lack of correlation between size of ovarian cysts and CA-125 levels provides a hint that the ovarian cyst epithelium does not directly express CA-125 and it may come from sites like the fallopian tube. Thus, raised level of CA-125 in benign ovarian cyst should be followed-up more closely, demanding assessment of fallopian tubes for early diagnosis of ovarian cancer. Also, algorithms can be explored to include size of ovarian cyst and CA 125 levels to predict ovarian cancer.

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A pilot study to establish non-invasive biomarkers for higher-grade meningioma

Neuro-Oncology ◽

10.1093/neuonc/noz167.023 ◽

2019 ◽

Vol 21 (Supplement_4) ◽

pp. iv6-iv6

Author(s):

Daniele Baiz ◽

Caterina Negroni ◽

Emanuela Ercolano ◽

Claire L Adams ◽

Kathreena M Kurian ◽

...

Keyword(s):

Ex Vivo ◽

Tumour Progression ◽

Primary Tumour ◽

Regulation Of Gene Expression ◽

Diagnostic Tools ◽

Malignant Tumours ◽

Liquid Biopsies ◽

Benign Meningioma ◽

Non Invasive ◽

Serum Exosomes

Abstract Introduction Meningioma brain tumours are the most common primary tumour in adults. Despite surgery and/or radiation therapy, meningioma may recur. The 5-year recurrence rate in benign meningioma is estimated in about 10% while much greater in atypical and malignant tumours. MicroRNAs (miRNAs) represent a large class of small RNAs driving regulation of gene expression and playing a role in tumour progression and therefore proposed as diagnostic tools. Moreover, miRNAs can be released from tumour cells into the blood stream via exosomes, showing potential to be used as liquid biopsies. Methods Identification of novel circulating biomarkers was conducted by performing an unbiased Cancer MicroRNA qPCR Array, followed by bioinformatics analysis. In parallel, we conducted a biased in silico analysis of the miRNAs targeting Cyclin D1 and E1, recently proposed as immunohistochemical meningioma biomarkers. Validation studies performed using TaqMan® reagents. Results Stringent unbiased (p<0.01) miRNA profiling followed by validation in ex vivo samples revealed that the miR-9-1 is upregulated in higher-grade meningioma tissues and serum exosomes, controlled by the EGFR/AP-1 axis and correlated with lower levels of E-Cadherin, a proposed biomarker for malignant meningioma. On the contrary, biased analysis, followed by validation in vitro and ex vivo, showed that the miR-497~195 cluster is downregulated in higher-grade meningioma tissues and serum exosomes, correlating with the overexpression of GATA-4, a novel meningioma tissue biomarker. Conclusion Our data demonstrated that both miR-497~195 and miR-9-1 show potential to become promising non-invasive biomarkers for higher-grade meningioma, reflecting their expression status in tissues. (DB and CN contributed equally).

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Meigs' syndrome with elevated CA 125: case report

Sao Paulo Medical Journal ◽

10.1590/s1516-31802003000500007 ◽

2003 ◽

Vol 121 (5) ◽

pp. 210-212 ◽

Cited By ~ 10

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.

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Application of microwave sensor technology in cardiovascular disease for plaque detection

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2016-0061 ◽

2016 ◽

Vol 2 (1) ◽

pp. 273-277 ◽

Cited By ~ 2

Author(s):

David Wagner ◽

Sebastian Vogt ◽

Farabi Ibne Jamal ◽

Subhajit Guha ◽

Christian Wenger ◽

...

Keyword(s):

Cardiovascular Disease ◽

Heart Surgery ◽

Sensor Technology ◽

Diagnostic Tools ◽

Screening Methods ◽

Minimal Size ◽

Microwave Sensor ◽

Early Diagnose ◽

Improved Methods ◽

Plaque Detection

AbstractArteriosclerosis and associated cardiovascular disease remains the leading cause of mortality. Improved methods for vascular plaque detection allow early diagnose and better therapeutic options. Present diagnostic tools require intense technical expenditure and diminish value of modern screening methods. Our group developed an microwave sensor for on-site detection of plaque formation in arterial vessels. The sensor is an oscillator working around 27 GHz which is coupled to a microstrip stub line. The final flexible polyimid interposer has a length of 38 cm, a width of 1.2 mm and a thickness of 200 μm. Because of its minimal size the interposer completed a catheter with a diameter of 8F ready for further clinical use in cardiology and heart surgery.

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Anastrozole and Levonorgrestrel-Releasing Intrauterine Device in the Treatment of Endometriosis: A Randomized Clinical Trial.

10.21203/rs.3.rs-51837/v4 ◽

2020 ◽

Author(s):

Pedro Acién ◽

Irene Velasco ◽

Maribel Acién

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Transvaginal Ultrasound ◽

Intrauterine Device ◽

Conservative Surgery ◽

University Hospital ◽

Ca 125 ◽

Fertility Sparing ◽

Ultrasound Guided Puncture ◽

Guided Puncture

Abstract Background: To study the effectiveness of an aromatase inhibitor (Anastrozole) associated to levonorgestrel-releasing intrauterine device (LNG-IUD, Mirena®) in the treatment of endometriosis.Methods: Prospective, randomized clinical trial. Setting: University Hospital (single center). Elegibility criteria: Endometriomas >3×4 cm, CA-125>35 U/mL and endometriosis symptoms. Patients: Thirty-one women randomized to anastrozole+Mirena®+Conservative Surgery(CS) (n=8), anastrozole+Mirena®+transvaginal ultrasound-guided puncture-aspiration (TUGPA) (n=7), Mirena®+CS (n=9), or Mirena®+TUGPA (n=7). Interventions: Anastrozole 1 mg/day and/or only Mirena® for 6 months; CS (ovarian and fertility-sparing) or TUGPA of endometriomas one month after starting medical treatment. Main Outcome Measures: Visual analogic scale for symptoms, CA-125 levels, ultrasound findings of endometriomas and recurrences. Results: A significant improvement in symptoms during the treatment (difference of 43%, 95% CI 29.9-56.2) occurred, which was maintained at 1 and 2 years. It was more significant in patients treated with anastrozole (51%, 95% CI 33.3-68.7). For CA-125, the most significant decrease was observed without anastrozole (73.8%, 95% CI 64.2-83.4 vs. 53.8%, 95% CI 25.7-81.6 under Mirena®+anastrozole). After CS for endometriosis, a reduction of findings of endometriomas and long-term recurrences occurred, with or without anastrozole. At 4,2±1,7 years (95% CI 3,57-4,85), 88% of the patients who underwent CS were asymptomatic, without medication or reoperation, compared to only 21% if TUGPA was performed, with or without anastrozole (p=0.019). Conclusions: Dosing anastrozole for 6 months, starting one month before CS of endometriosis, reduces more significantly the painful symptoms and delays recurrences, but has no other significant advantages over the single insertion of LNG-IUD (Mirena®) during the same time. Anastrozole and/or only Mirena® associated with TUGPA are not effective.

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Anastrozole and Levonorgrestrel-Releasing Intrauterine Device in the Treatment of Endometriosis: A Randomized Clinical Trial.

10.21203/rs.3.rs-51837/v2 ◽

2020 ◽

Author(s):

Pedro Acién ◽

Irene Velasco ◽

Maribel Acién

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Transvaginal Ultrasound ◽

Intrauterine Device ◽

Conservative Surgery ◽

University Hospital ◽

Ca 125 ◽

European Medicines Agency ◽

Fertility Sparing ◽

Ultrasound Guided Puncture

Abstract Background: To study the effectiveness of an aromatase inhibitor (Anastrozole) associated to levonorgestrel-releasing intrauterine device (LNG-IUD, Mirena®) in the treatment of endometriosis.Methods: Prospective, randomized clinical trial. Setting: University Hospital (single center). Elegibility criteria: Endometriomas >3×4 cm, CA-125>35 U/mL and endometriosis symptoms. Patients: Thirty-one women randomized to anastrozole+Mirena®+Conservative Surgery(CS) (n=8), anastrozole+Mirena®+transvaginal ultrasound-guided puncture-aspiration (TUGPA) (n=7), Mirena®+CS (n=9), or Mirena®+TUGPA (n=7). Interventions: Anastrozole 1 mg/day and/or only Mirena® for 6 months; CS (ovarian and fertility-sparing) or TUGPA of endometriomas one month after starting medical treatment. Main Outcome Measures: Visual analogic scale for symptoms, CA-125 levels, ultrasound findings of endometriomas and recurrences.Results: A significant improvement in symptoms during the treatment (difference of 43%, 95% CI 29.9-56.2) occurred, which was maintained at 1 and 2 years. It was more significant in patients treated with anastrozole (51%, 95% CI 33.3-68.7). For CA-125, the most significant decrease was observed without anastrozole (73.8%, 95% CI 64.2-83.4 vs. 53.8%, 95% CI 25.7-81.6 under Mirena®+anastrozole). After CS for endometriosis, a reduction of findings of endometriomas and long-term recurrences occurred, with or without anastrozole. At 4,2±1,7 years (95% CI 3,57-4,85), 88% of the patients who underwent CS were asymptomatic, without medication or reoperation, compared to only 21% if TUGPA was performed, with or without anastrozole (p=0.019).Conclusions: Dosing anastrozole for 6 months, starting one month before CS of endometriosis, reduces more significantly the painful symptoms and delays recurrences, but has no other significant advantages over the single insertion of LNG-IUD (Mirena®) during the same time. Anastrozole and/or only Mirena® associated with TUGPA are not effective.Details of trial registration: Eudra CT System of the European Medicines Agency (London, 29-Sept-2008) Nº EudraCT: 2008-005744-17 (07/11/2008). Date of enrolment of first patient: 15/01/2009.

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Abdominal tuberculosis with a Pseudo-Sister Mary Joseph nodule mimicking peritoneal carcinomatosis

BMJ Case Reports ◽

10.1136/bcr-2019-229624 ◽

2019 ◽

Vol 12 (6) ◽

pp. e229624 ◽

Cited By ~ 1

Author(s):

Amine Awad ◽

Tom Pampiglione ◽

Zaker Ullah

Keyword(s):

Transvaginal Ultrasound ◽

Positive Culture ◽

Ct Scanning ◽

Abdominal Tuberculosis ◽

Tumour Marker ◽

Interferon Γ ◽

Ca 125 ◽

Fluid Analysis ◽

Release Assay ◽

Sister Mary Joseph

A 46-year-old woman presented in severe abdominal pain on a background of 3 months of weight loss and intermittent vomiting. She had visited East Africa 6 months prior but reported no unwell contacts. On examination, she had generalised abdominal tenderness, distension and a painful paraumbilical swelling. CT scanning confirmed small bowel obstruction and revealed widespread peritoneal nodules, lymphadenopathy, ascites and a soft tissue paraumbilical mass. CA-125 tumour marker was elevated. However, transvaginal ultrasound scanning showed normal-appearing ovaries. She underwent a diagnostic laparoscopy for ascitic fluid analysis and biopsy of omental and peritoneal nodules, which revealed a lymphocytic exudate and caseating granulomas, respectively. Interferon-γ release assay and repeated stains for acid-fast bacilli were negative. She was commenced on antituberculous chemotherapy for a presumed diagnosis of abdominal tuberculosis. Positive culture results 2 weeks later confirmed Mycobacterium tuberculosis infection. The patient experienced a complete resolution of symptoms within 6 weeks of treatment.

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Development of a Multimarker Assay for Early Detection of Ovarian Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2008.19.2484 ◽

2010 ◽

Vol 28 (13) ◽

pp. 2159-2166 ◽

Cited By ~ 178

Author(s):

Zoya Yurkovetsky ◽

Steven Skates ◽

Aleksey Lomakin ◽

Brian Nolen ◽

Trenton Pulsipher ◽

...

Keyword(s):

Ovarian Cancer ◽

Early Detection ◽

Late Stage ◽

Early Stage ◽

Screening Strategy ◽

Ca 125 ◽

Great Promise ◽

Biomarker Panel ◽

Healthy Women ◽

Early Stage Ovarian Cancer

PurposeEarly detection of ovarian cancer has great promise to improve clinical outcome.Patients and MethodsNinety-six serum biomarkers were analyzed in sera from healthy women and from patients with ovarian cancer, benign pelvic tumors, and breast, colorectal, and lung cancers, using multiplex xMAP bead-based immunoassays. A Metropolis algorithm with Monte Carlo simulation (MMC) was used for analysis of the data.ResultsA training set, including sera from 139 patients with early-stage ovarian cancer, 149 patients with late-stage ovarian cancer, and 1,102 healthy women, was analyzed with MMC algorithm and cross validation to identify an optimal biomarker panel discriminating early-stage cancer from healthy controls. The four-biomarker panel providing the highest diagnostic power of 86% sensitivity (SN) for early-stage and 93% SN for late-stage ovarian cancer at 98% specificity (SP) was comprised of CA-125, HE4, CEA, and VCAM-1. This model was applied to an independent blinded validation set consisting of sera from 44 patients with early-stage ovarian cancer, 124 patients with late-stage ovarian cancer, and 929 healthy women, providing unbiased estimates of 86% SN for stage I and II and 95% SN for stage III and IV disease at 98% SP. This panel was selective for ovarian cancer showing SN of 33% for benign pelvic disease, SN of 6% for breast cancer, SN of 0% for colorectal cancer, and SN of 36% for lung cancer.ConclusionA panel of CA-125, HE4, CEA, and VCAM-1, after additional validation, could serve as an initial stage in a screening strategy for epithelial ovarian cancer.

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Clinically Correlated MicroRNAs in the Diagnosis of Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2018/5930951 ◽

2018 ◽

Vol 2018 ◽

pp. 1-14 ◽

Cited By ~ 5

Author(s):

Min Jiang ◽

Xuelian Li ◽

Xiaowei Quan ◽

Xiaoying Li ◽

Baosen Zhou

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Meta Analysis ◽

Area Under The Curve ◽

Diagnostic Value ◽

Small Cell ◽

Diagnostic Tools ◽

Small Cell Lung ◽

Diagnostic Efficacy

(1) Background. Non-small cell lung cancer (NSCLC) has a high mortality rate. MiRNAs have been found to be diagnostic biomarkers for NSCLC. However, controversial results exist. We conducted this meta-analysis to evaluate the diagnostic value of miRNAs for NSCLC.(2) Methods. Databases and reference lists were searched. Pooled sensitivity (SEN), specificity (SPE), and area under the curve (AUC) were applied to examine the general diagnostic efficacy, and subgroup analysis was also performed.(3) Results. Pooled SEN, SPE, and AUC were 85%, 88%, and 0.93, respectively, for 71 studies. Multiple miRNAs (AUC: 0.96) obtained higher diagnostic value than single miRNA (AUC: 0.86), and the same result was found for Caucasian population (AUC: 0.97) when compared with Asian (AUC: 0.91) and Caucasian/African population (AUC: 0.92). MiRNA had higher diagnostic efficacy when participants contained both smokers and nonsmokers (AUC is 0.95 for imbalanced group and 0.91 for balanced group) than when containing only smokers (AUC: 0.90). Meanwhile, AUC was 0.91 for both miR-21 and miR-210.(4) Conclusions. Multiple miRNAs such as miR-21 and miR-210 could be used as diagnostic tools for NSCLC, especially for the Caucasian and nonsmoking NSCLC.

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