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Journal article

A prospective evaluation of early detection biomarkers for ovarian cancer in the European EPIC cohort.

Abstract:

Purpose

About 60% of ovarian cancers are diagnosed at late stage, when5-year survival is less than 30% in contrast to 90% for local disease. This has prompted search for early detection biomarkers. For initial testing, specimens taken months or years before ovarian cancer diagnosis are the best source of information to evaluate early detection biomarkers. Here we evaluate the most promising ovarian cancer screening biomarkers in prospectively collected samples from the European Prospective Investigation into Cancerand Nutrition study.

Experimental Design

We measured CA125, HE4, CA72.4 and CA15.3 in 810 invasive epithelial ovarian cancer cases and 1,939 controls. We calculated the sensitivity at 95% and 98% specificity as well as Area under the Receiver Operator Curve (C-statistic) for each marker individually and in combination. Additionally, we evaluated marker performance by stage at diagnosis and time between blood draw and diagnosis.

Results

We observed the best discrimination between cases and controlswithin six months of diagnosis for CA125 (C-statistic=0.92), then HE4 (0.84), CA72.4 (0.77), and CA15.3 (0.73). Marker performance declined with longer time between blood draw and diagnosis and for earlier staged disease. However, assessment of discriminatory ability at early stage was limited by small numbers. Combinations of markers performed modestly, but significantly better than any single marker.

Conclusions

CA125 remains the single best marker for the early detection of invasive epithelial ovarian cancer, but can be slightly improved by combining with other markers. Identifying novel markers for ovarian cancer will require studies including larger numbers of early stage cases.

Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1158/1078-0432.CCR-16-0316

Authors



Publisher:
American Association for Cancer Research
Journal:
Clinical Cancer Research More from this journal
Volume:
22
Issue:
18
Pages:
4664-4675
Publication date:
2016-04-08
Acceptance date:
2016-03-21
DOI:
EISSN:
1078-0432
ISSN:
1078-0432


Language:
English
Keywords:
Pubs id:
pubs:617630
UUID:
uuid:03700a7e-3e18-4811-8299-a3ba3fb88ec0
Local pid:
pubs:617630
Source identifiers:
617630
Deposit date:
2016-05-04
ARK identifier:

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