Introduction/Background*Trial on five plasma biomarkers (CA125 – cancer antigen 125, HE4 – human epididymis protein 4, OPN - osteopontin, leptin, prolactin) and their possible role in differentiating benign from malignant ovarian tumors.
Methodology In this unicentric prospective trial preoperative blood samples of 43 women with ovarian masses determined for ovarian surgery were analyzed. 25 patients had pathologically confirmed benign, 18 malignant ovarian tumors. Blood plasma was analyzed for CA125, HE4, OPN, leptin, prolactin and MIF (macrophage migration inhibitory factor) by multiplex immunoassay analysis. Each single protein and a logistic regression model including all the listed proteins were tested as preoperative predictive marker for suspect ovarian masses.
Result(s)*Plasma CA125 was confirmed as a highly accurate tumor marker in ovarian cancer. HE4, OPN, leptin and prolactin plasma levels differed significantly between benign and malignant ovarian masses. With a logistic regression model a formula including CA125, HE4, OPN, leptin and prolactin was developed to predict malignant ovarian tumors. With a discriminatory AUC (area under the curve) of 0.96 it showed to be a highly sensitive and specific diagnostic test for a malignant ovarian tumor.
Conclusion*The calculated formula with the combination of CA125, HE4, OPN, leptin and prolactin plasma levels surpasses each single marker in its diagnostic value to discriminate between benign and malignant ovarian tumors. The formula, applied to our patient population was highly accurate but should be validated in a larger cohort.
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