Serum placental-type alkaline phosphatase activity in women with squamous and glandular malignancies of the reproductive tract

Systematic bioinformatic analysis of expression levels of 17,330 human genes across 9,783 samples from 175 types of healthy and pathological tissues

Our knowledge on tissue- and disease-specific functions of human genes is rather limited and highly context-specific. Here, we have developed a method for the comparison of mRNA expression levels of most human genes across 9,783 Affymetrix gene expression array experiments representing 43 normal human tissue types, 68 cancer types, and 64 other diseases. This database of gene expression patterns in normal human tissues and pathological conditions covers 113 million datapoints and is available from the GeneSapiens website.

Pelvic tumours in adolescence

Malignant pelvic tumours in adolescents are rare. Cancers most commonly associated with adolescent women are ovarian germ-cell tumours, ovarian stromal tumours, genital rhabdomyosarcomas and cervico-vaginal clear-cell adenocarcinomas. The incidence of the last of these has reduced with the abandonment of diethylstilbestrol (stilboestrol) therapy in pregnancy. With sexual activity among adolescent women increasing, the incidence of cervical cancer and gestational trophoblastic tumours is rising. Treatment for pelvic cancers in adolescence should be in a multidisciplinary setting and in most cases surgery should be conservative with the aim of preserving sexual and reproductive function. With a few notable exceptions, the prognosis for most malignant pelvic tumours that occur in adolescence is good and treatment is with curative intent.

Serum concentrations of cancer antigen 125, placental alkaline phosphatase, cancer-associated serum antigen and free beta human chorionic gonadotrophin as prognostic markers for epithelial ovarian cancer

OBJECTIVE

To investigate the prognostic significance of elevated levels of cancer antigen 125 (CA125), placental alkaline phosphatase (PLAP), free beta human chorionic gonadotrophin (hCG) and cancer-associated serum antigen (CASA) in women with primary epithelial ovarian carcinoma.

DESIGN

A two year follow up study of survival.

SETTING

A tertiary care gynaecological oncology unit.

PARTICIPANTS

One hundred and eleven women with histologically confirmed epithelial ovarian cancer.

MAIN OUTCOME MEASURES

Survival over a two year period.

RESULTS

Stage corrected log-rank chi 2 tests demonstrated a significant effect on survival for all four tumour markers (CA125 P = 0.0142; PLAP P < 0.0001; CASA P = 0.0098; hCG P = 0.0002). This was confirmed when each variable was fitted together with disease stage in Cox proportional hazard models. When fitted as multiple variables in a Cox proportional hazard model, the addition of free beta-hCG and CASA to disease stage, PLAP concentrations and CA125 levels did not demonstrate further prognostic value.

CONCLUSIONS

Levels of all four markers correlate with survival in patients with epithelial ovarian cancer. The combination of PLAP and CA125 concentrations together with disease stage may be used to predict survival but the addition of hCG and CASA levels do not give additional prognostic information.