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A Proteomics Panel for Predicting Optimal Primary Cytoreduction in Stage III/IV Ovarian Cancer
  1. Signe Risum*,
  2. Estrid Høgdall,
  3. Svend A. Engelholm*,
  4. Eric Fung,
  5. Lee Lomas,
  6. Christine Yip,
  7. Anette L. Petri§,
  8. Lotte Nedergaard,
  9. Lene Lundvall§ and
  10. Claus Høgdall§
  1. * Department of Oncology, Finsen Center, Rigshospitalet; and
  2. Department of Pathology, National Biobank, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark;
  3. Vermillion, Inc, Fremont, CA; and
  4. § Gynecologic Clinic, Juliane-Marie Center, and
  5. Department of Pathology, Center of Diagnostic Investigations, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  1. Address correspondence and reprint requests to Signe Risum, Department of Oncology, 5073, Finsen Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark. E-mail: signerisum{at}


The objective of this prospective study was to evaluate CA-125 and a 7-marker panel as predictors of incomplete primary cytoreduction in patients with stage III/IV ovarian cancer (OC). From September 2004 to January 2008, serum from 201 patients referred to surgery for a pelvic tumor was analyzed for CA-125. In addition, serum was analyzed for 7 biomarkers using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. These biomarkers were combined into a single-valued ovarian-cancer-risk index (OvaRI). CA-125 and OvaRI were evaluated as predictors of cytoreduction in 75 stage III/IV patients using receiver operating characteristic curves.

Complete primary cytoreduction (no macroscopic residual disease) was achieved in 31% (23/75) of the patients. The area under the receiver operating characteristic curve was 0.66 for CA-125 and 0.75 for OvaRI.

The sensitivity and specificity of CA-125 for predicting incomplete cytoreduction were 71% (37/52) and 57% (13/23), respectively (P = 0.04). The sensitivity and specificity of OvaRI for predicting incomplete cytoreduction were 73% (38/52) and 70% (16/23), respectively (P = 0.001). In conclusion, CA-125 and an index of 7 biomarkers were found to be predictors of cytoreduction. However, future studies of biomarkers are anticipated to promote early diagnosis and provide prognostic information to guide treatment of OC patients. In addition, new biomarkers might also play a role in predicting outcome from primary surgery in OC patients.

  • Proteomics
  • CA-125
  • Prediction of cytoreduction
  • Primary ovarian cancer

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