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Chen L, Jin C, Chen B, Debora A, Su W, Zhou Q, Zhou S, Bian J, Yang Y, Lan L. A dual-center study: can ultrasound radiomics differentiate type I and type II epithelial ovarian cancer patients with normal CA125 levels? Br J Radiol 2024; 97:1706-1712. [PMID: 39177575 PMCID: PMC11417353 DOI: 10.1093/bjr/tqae144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/19/2024] [Accepted: 08/07/2024] [Indexed: 08/24/2024] Open
Abstract
OBJECTIVE CA125 is recommended by many countries as the primary screening test for ovarian cancer. But there are patients with ovarian cancer having normal CA125. We hope to identify the types of EOC with normal CA125 levels better by building a refined model based on the ultrasound radiomics, thus providing precise medical treatment for patients. METHODS We included 58 patients with EOC with normal CA125 from 2 centres, who were confirmed by preoperative ultrasound and pathology. We extracted 1130 radiomics features based on the tumour's region of interest from the most typical ultrasound image of each patient. We selected radiomics and clinical features by LASSO and logistic regression to construct Rad-score and clinical models, respectively. Receiver operating characteristic curves judged their test efficacy. On the basis of the combined model, we developed a nomogram. RESULTS Area under the curves (AUCs) of 0.93 and 0.83 were achieved in both the training and test groups for the combined model. There were similar AUCs between the Rad-score and clinical models of 0.82 and 0.80, respectively. By analysing the calibration curves, it was determined that the nomogram matched actual observations in the training cohort. CONCLUSION Ultrasound radiomics can differentiate type I and type II EOC with normal CA125 levels. ADVANCES IN KNOWLEDGE This study is the first to focus on EOC cases with normal level of CA125. The subset of patients constituting 20% of the disease population may require more refined radiomics models.
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Affiliation(s)
- Lixuan Chen
- The Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Chenyang Jin
- Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
| | - Bo Chen
- The Department of Medical Record, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Asta Debora
- The Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Weizeng Su
- The Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Qingwen Zhou
- The Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Shuai Zhou
- The Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jinyan Bian
- Department of Obstetrics and Gynecology Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
| | - Yunjun Yang
- The Department of Nuclear, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Li Lan
- The Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
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Yang F, Yan L, Ji J, Lou Y, Zhu J. HER2 puzzle pieces: Non-Coding RNAs as keys to mechanisms, chemoresistance, and clinical outcomes in Ovarian cancer. Pathol Res Pract 2024; 258:155335. [PMID: 38723327 DOI: 10.1016/j.prp.2024.155335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/23/2024] [Accepted: 04/27/2024] [Indexed: 05/29/2024]
Abstract
Ovarian cancer (OC) presents significant challenges, characterized by limited treatment options and therapy resistance often attributed to dysregulation of the HER2 signaling pathway. Non-coding RNAs (ncRNAs) have emerged as key players in regulating gene expression in OC. This comprehensive review underscores the pivotal role of ncRNAs in modulating HER2 signaling, with a specific focus on their mechanisms, impact on chemoresistance, and prognostic/diagnostic implications. MicroRNAs, long non-coding RNAs, and circular RNAs have been identified as essential regulators in the modulation of the HER2 pathway. By directly targeting key components of the HER2 axis, these ncRNAs influence its activation and downstream signaling cascades. Dysregulated ncRNAs have been closely associated with chemoresistance, leading to treatment failures and disease progression in OC. Furthermore, distinct expression profiles of ncRNAs hold promise as reliable prognostic and diagnostic markers, facilitating personalized treatment strategies and enhancing disease outcome assessments. A comprehensive understanding of how ncRNAs intricately modulate HER2 signaling is imperative for the development of targeted therapies and the improvement of patient outcomes. The integration of ncRNA profiles into clinical practice has the potential to enhance prognostic and diagnostic accuracy in the management of ovarian cancer. Further research efforts are essential to validate the clinical utility of ncRNAs and elucidate their precise roles in the regulation of HER2 signaling. In conclusion, ncRNAs play a crucial role in governing HER2 signaling in ovarian cancer, impacting chemoresistance and providing valuable prognostic and diagnostic insights. The exploration of ncRNA-mediated HER2 modulation offers promising avenues for the development of personalized treatment approaches, ultimately advancing patient care and outcomes in OC.
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Affiliation(s)
- Fangwei Yang
- Obstetrical Department, Yiwu Central Hospital, Yiwu, Zhejiang 322000, China.
| | - Lixiang Yan
- Obstetrical Department, Yiwu Central Hospital, Yiwu, Zhejiang 322000, China
| | - Junnan Ji
- Obstetrical Department, Yiwu Central Hospital, Yiwu, Zhejiang 322000, China
| | - Yunxia Lou
- Obstetrical Department, Yiwu Central Hospital, Yiwu, Zhejiang 322000, China
| | - Jinlu Zhu
- Obstetrical Department, Yiwu Central Hospital, Yiwu, Zhejiang 322000, China
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Mishra Y, Chattaraj A, Mishra V, Ranjan A, Tambuwala MM. Aptamers Versus Vascular Endothelial Growth Factor (VEGF): A New Battle against Ovarian Cancer. Pharmaceuticals (Basel) 2023; 16:849. [PMID: 37375796 DOI: 10.3390/ph16060849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/28/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Cancer is one of the diseases that causes a high mortality as it involves unregulated and abnormal cell growth proliferation that can manifest in any body region. One of the typical ovarian cancer symptoms is damage to the female reproductive system. The death rate can be reduced through early detection of the ovarian cancer. Promising probes that can detect ovarian cancer are suitable aptamers. Aptamers, i.e., so-called chemical antibodies, have a strong affinity for the target biomarker and can typically be identified starting from a random library of oligonucleotides. Compared with other probes, ovarian cancer targeting using aptamers has demonstrated superior detection effectiveness. Various aptamers have been selected to detect the ovarian tumor biomarker, vascular endothelial growth factor (VEGF). The present review highlights the development of particular aptamers that target VEGF and detect ovarian cancer at its earliest stages. The therapeutic efficacy of aptamers in ovarian cancer treatment is also discussed.
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Affiliation(s)
- Yachana Mishra
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, Punjab, India
| | - Aditi Chattaraj
- School of Bioengineering and Biosciences, Lovely Professional University, Phagwara 144411, Punjab, India
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India
| | - Abhigyan Ranjan
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India
| | - Murtaza M Tambuwala
- Lincoln Medical School, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
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Zhang R, Siu MKY, Ngan HYS, Chan KKL. Molecular Biomarkers for the Early Detection of Ovarian Cancer. Int J Mol Sci 2022; 23:ijms231912041. [PMID: 36233339 PMCID: PMC9569881 DOI: 10.3390/ijms231912041] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
Ovarian cancer is the deadliest gynecological cancer, leading to over 152,000 deaths each year. A late diagnosis is the primary factor causing a poor prognosis of ovarian cancer and often occurs due to a lack of specific symptoms and effective biomarkers for an early detection. Currently, cancer antigen 125 (CA125) is the most widely used biomarker for ovarian cancer detection, but this approach is limited by a low specificity. In recent years, multimarker panels have been developed by combining molecular biomarkers such as human epididymis secretory protein 4 (HE4), ultrasound results, or menopausal status to improve the diagnostic efficacy. The risk of ovarian malignancy algorithm (ROMA), the risk of malignancy index (RMI), and OVA1 assays have also been clinically used with improved sensitivity and specificity. Ongoing investigations into novel biomarkers such as autoantibodies, ctDNAs, miRNAs, and DNA methylation signatures continue to aim to provide earlier detection methods for ovarian cancer. This paper reviews recent advancements in molecular biomarkers for the early detection of ovarian cancer.
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Li R, Ma S, Zu Y, Wang F, Gao T, Yang Y, Guo H, Ha C. Value of the risk of ovarian malignancy algorithm index in predicting the recurrence of epithelial ovarian cancer. Biomark Med 2022; 16:1055-1066. [PMID: 36062577 DOI: 10.2217/bmm-2022-0287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Aim: This study aimed to assess the predictive and diagnostic value of the risk of ovarian malignancy algorithm (ROMA) index for epithelial ovarian cancer (EOC) recurrence. Materials & methods: The clinical features and follow-up data of 159 EOC cases were studied. The ROMA index was calculated by serum CA125 and HE4 levels with menopausal status. Recurrence-free survival was evaluated for an end point. Results: The ROMA was strongly associated with clinical characteristics. The ROMA index above the cutoff value (34.71%) was significantly associated with recurrence-free survival. The ROMA index had a significantly higher sensitivity (90.59%) than CA125 (84.71%) and HE4 (80.80%) for recurrence diagnosis, and its optimal cutoff value was 17.07%. Conclusion: The primary ROMA index is a predictive factor in EOC recurrence and has better performance in the diagnosis of EOC recurrence.
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Affiliation(s)
- Ruyue Li
- School of Clinical Medicine, Ningxia Medical University, Yinchuan Ningxia, 750000, China
| | - Shaohan Ma
- School of Clinical Medicine, Ningxia Medical University, Yinchuan Ningxia, 750000, China
| | - Yizheng Zu
- School of Clinical Medicine, Ningxia Medical University, Yinchuan Ningxia, 750000, China
| | - Fang Wang
- People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, 750000, China
| | - Tingting Gao
- School of Clinical Medicine, Ningxia Medical University, Yinchuan Ningxia, 750000, China
| | - Yu'e Yang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan Ningxia, 750000, China
| | - Hua Guo
- Gynecology Department, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750000, China
| | - Chunfang Ha
- Gynecology Department, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750000, China.,Key Laboratory of Fertility Preservation & Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, 750000, China
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Alegría-Baños JA, Jiménez-López JC, Vergara-Castañeda A, de León DFC, Mohar-Betancourt A, Pérez-Montiel D, Sánchez-Domínguez G, García-Villarejo M, Olivares-Pérez C, Hernández-Constantino Á, González-Santiago A, Clara-Altamirano M, Arela-Quispe L, Prada-Ortega D. Kinetics of HE4 and CA125 as prognosis biomarkers during neoadjuvant chemotherapy in advanced epithelial ovarian cancer. J Ovarian Res 2021; 14:96. [PMID: 34275472 PMCID: PMC8287739 DOI: 10.1186/s13048-021-00845-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Ovarian cancer (OC) is considered the most lethal gynecological cancer, of which more than 65% cases are diagnosed in advanced stages, requiring platinum-based neoadjuvant chemotherapy (NACT). METHODS A prospective-longitudinal study was conducted among women with advanced epithelial ovarian cancer (AEOC), III and IV stages, and treated with NACT, at the National Cancer Institute - Mexico, from July 2017 to July 2018. Serum samples were obtained for quantification of CA125 and HE4 using ELISA at the first and in each of the three NACT cycles. The therapeutic response was evaluated through standard tomography. We determined whether CA125 and HE4, alone or in combination, were associated with TR to NACT during follow up. RESULTS 53 patients aged 38 to 79 years were included, 92.4% presented papillary serous subtype OC. Higher serum HE4 levels were observed in patients with non-tomographic response (6.89 vs 5.19 pmol/mL; p = 0.031), specially during the second (p = 0.039) and third cycle of NACT (p = 0.031). Multivariate-adjusted models showed an association between HE4 levels and TR, from the second treatment cycle (p = 0.042) to the third cycle (p = 0.033). Changes from baseline HE4 levels during the first cycle was negative associated with TR. No associations were found between CA125 and TR. CONCLUSIONS Serum HE4 levels were independently associated with TR among patients with AOEC treated with NACT, also a reduction between baseline HE4 and first chemotherapy levels was also independently associated with the TR. These findings might be relevant for predicting a lack of response to treatment.
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Affiliation(s)
- Jorge A Alegría-Baños
- Oncology Center, Médica Sur, Mexico City, Mexico.
- Chemical Sciences Faculty, Universidad La Salle, Benjamín Franklin 45, 06140, Mexico City, Mexico.
| | - José C Jiménez-López
- Science Faculty, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Arely Vergara-Castañeda
- Chemical Sciences Faculty, Universidad La Salle, Benjamín Franklin 45, 06140, Mexico City, Mexico
| | - David F Cantú de León
- Instituto Nacional de Cancerología, Colonia Seccion XVI, San Fernando 22, 14080, Tlalpan, Mexico City, Mexico
| | - Alejandro Mohar-Betancourt
- Instituto Nacional de Cancerología, Colonia Seccion XVI, San Fernando 22, 14080, Tlalpan, Mexico City, Mexico
| | - Delia Pérez-Montiel
- Instituto Nacional de Cancerología, Colonia Seccion XVI, San Fernando 22, 14080, Tlalpan, Mexico City, Mexico
| | | | | | | | | | | | | | - Liz Arela-Quispe
- Department of Molecular Imaging, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Diddier Prada-Ortega
- Instituto Nacional de Cancerología, Colonia Seccion XVI, San Fernando 22, 14080, Tlalpan, Mexico City, Mexico.
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA.
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Huang X, Wang Z, Zhang M, Luo H. Diagnostic Accuracy of the ADNEX Model for Ovarian Cancer at the 15% Cut-Off Value: A Systematic Review and Meta-Analysis. Front Oncol 2021; 11:684257. [PMID: 34222006 PMCID: PMC8247918 DOI: 10.3389/fonc.2021.684257] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/24/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives To evaluate the diagnostic accuracy of the ADNEX model for ovarian cancer at the 15% cut-off value. Methods Studies on the identified diagnosis of the ADNEX model for ovarian cancer published in PubMed, Embase, the Cochrane Library and Web of Science databases from January 1st, 2014 to February 20th, 2021 were searched. Two researchers independently screened the retrieved studies and extracted the basic features and parameter data. The quality of the eligible studies was evaluated by Quality Assessment of Diagnostic Accuracy Studies-2, and the result was summarized by Review Manager 5.3. Meta-Disc 1.4 and STATA 16.0 were used in statistical analysis. Heterogeneity of this meta-analysis was calculated. Meta-regression was performed to investigate the potential sources of heterogeneity. Sensitivity analysis and Deek's funnel plot analysis were conducted to evaluate the stability and publication bias, respectively. Results 280 studies were initially retrieved through the search strategy, and 10 eligible studies were ultimately included. The random-effects model was selected for data synthesis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and the area under the summary receiver operating characteristic curve were 0.92 (95% CI: 0.89-0.94), 0.82 (95% CI: 0.78-0.86), 5.2 (95% CI: 4.1-6.4), 0.10 (95% CI: 0.07-0.13), 54.0 (95% CI: 37.0-77.0) and 0.95 (95% CI: 0.91-0.95). Meta-regression based on study design, country, enrollment and blind method was not statistically significant. This meta-analysis was stable with no obvious publication bias. Conclusions The ADNEX model at the 15% cut-off had high diagnostic accuracy in identifying ovarian cancer.
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Affiliation(s)
- Xiaotong Huang
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China
| | - Ziwei Wang
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China
| | - Meiqin Zhang
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China
| | - Hong Luo
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China
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