1
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Kus F, Guven DC, Yildirim HC, Chalabiyev E, Akyildiz A, Tatar OD, Sahin YB, Ileri S, Karaca E, Kertmen N, Arik Z. KELIM score predicts outcome in patients with platinum-resistant/refractory recurrent ovarian cancer. Biomark Med 2023; 17:379-389. [PMID: 37309756 DOI: 10.2217/bmm-2022-0923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Aim: To assess the prognostic role of the CA-125 elimination rate constant K (KELIM) score in platinum-resistant/refractory ovarian cancer patients receiving second-line treatment. Methods: A retrospective study was carried out including 117 patients with advanced-stage platinum-resistant/refractory ovarian cancer treated with liposomal doxorubicin ± bevacizumab. The KELIM score, calculated using CA-125 measurements within the first 100 days of chemotherapy, was used. Survival analyses were performed for overall survival (OS) and progression-free survival (PFS). Results: Higher KELIM scores were associated with a superior PFS and OS. Multivariate analysis confirmed the independent prognostic value of the KELIM score for OS. Validation cohorts showed consistent results. Conclusion: KELIM score may serve as a valuable prognostic marker for predicting OS and PFS in platinum-resistant/refractory ovarian cancer patients receiving second-line treatment. Prospective studies are needed for validation.
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Affiliation(s)
- Fatih Kus
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz C Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Hasan C Yildirim
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Elvin Chalabiyev
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Arif Akyildiz
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Omer D Tatar
- Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Yigit B Sahin
- Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Serez Ileri
- Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Ece Karaca
- Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Neyran Kertmen
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Zafer Arik
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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2
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Assidi M. High N-Cadherin Protein Expression in Ovarian Cancer Predicts Poor Survival and Triggers Cell Invasion. Front Oncol 2022; 12:870820. [PMID: 35574323 PMCID: PMC9096138 DOI: 10.3389/fonc.2022.870820] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/04/2022] [Indexed: 12/05/2022] Open
Abstract
Ovarian cancer (OC) is among the most lethal cancer among all gynaecological malignancies. Since most OC patients are diagnosed only at advanced stages mainly because of their imperceptible/nonspecific symptoms, survival rates are low. Therefore, more molecular biomarkers are needed to achieve more effective molecular stratification for better prognostic and theranostic outcomes. The cadherin family, particularly N-cadherin (N-CAD; also known as CDH2), is critical for cell-cell adhesion and epithelial- mesenchymal transition (EMT) of cancer. N-CAD protein has also been shown to be overexpressed in many advanced carcinomas. The aim of this study was to investigate the expression patterns of N-CAD protein, determine their correlations with the clinicopathological features of OC patients, and evaluate its prognostic value and involvement in EMT and metastasis. Protein expression of N-CAD was studied in 117 formalin-fixed and paraffin-embedded (FFPE) blocks from patients diagnosed with OC using Tissue Microarray and immunohistochemistry techniques. The N-CAD protein was overexpressed in 58% of our OC cohort. Furthermore, its cytoplasmic overexpression was significantly correlated with tumor grade (p= 0.05), tumor subtype (p= 0.05), tumor necrosis (p= 0.01), and age at menarche (p= 0.002). Interestingly, Kaplan-Meier analysis showed a significant correlation of disease-free survival (DFS) with OC patients with cytoplasmic N-CAD overexpression (p< 0.03, log rank). Patients with high N-CAD expression have approximately twice the recurrence rate at 5-year follow-up. The results of this study demonstrate a poor prognostic role of N-CAD overexpression in OC, which is reflected in higher recurrence and death rates of OC and its molecular contribution to EMT and distant metastasis. Therefore, OC patients with overexpressed N-CAD need to be monitored more frequently and closely. Further studies with larger patient cohorts are needed to validate these findings, demystify the role of N-CAD in OC pathophysiology, and further investigate its role as a potential therapeutic target.
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Affiliation(s)
- Mourad Assidi
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Medical Laboratory Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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3
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Králíčková M, Vetvicka V, Fiala L, Laganà AS, Garzon S. The Search for Biomarkers in Endometriosis: a Long and Windy Road. Reprod Sci 2021; 29:1667-1673. [PMID: 34159571 DOI: 10.1007/s43032-021-00668-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/11/2021] [Indexed: 01/29/2023]
Abstract
Endometriosis is a complex and chronic estrogen-dependent disease, affecting a significant proportion of women of reproductive age. Despite the long interest and extensive research, the pathogenesis of the disease is still debated. Although available non-invasive diagnostic methods have adequate accuracy, an invasive approach by laparoscopy is often necessary to obtain histological confirmation. In this scenario, the search for an accurate, reliable, cost-effective, clinically applicable non-invasive biomarker plays a crucial role in a potentially early diagnosis and, in this way, shape the future management of the disease. Considering these elements, the current review aims to summarize the most significant and novel results about biomarkers for the diagnosis and follow-up of women affected by endometriosis.
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Affiliation(s)
- Milena Králíčková
- Department of Histology and Embryology, Faculty of Medicine, Charles University, Pilsen, Czech Republic.,Department of Obstetrics and Gynecology, University Hospital, Faculty of Medicine, Charles University, Pilsen, Czech Republic.,Biomedical Centre, Faculty of Medicine in Plzen, Charles University, Pilsen, Czech Republic
| | - Vaclav Vetvicka
- Department of Pathology, University of Louisville, Louisville, KY, USA
| | - Luděk Fiala
- Institute of Sexology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Piazza Biroldi 1, 21100, Varese, Italy.
| | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Piazza Biroldi 1, 21100, Varese, Italy.,Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
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4
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Al-Dossary AA, Tawfik EA, Isichei AC, Sun X, Li J, Alshehri AA, Alomari M, Almughem FA, Aldossary AM, Sabit H, Almalik AM. Engineered EV-Mimetic Nanoparticles as Therapeutic Delivery Vehicles for High-Grade Serous Ovarian Cancer. Cancers (Basel) 2021; 13:cancers13123075. [PMID: 34203051 PMCID: PMC8234974 DOI: 10.3390/cancers13123075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary In this review, we begin with the role of natural extracellular vesicles (EVs) in high-grade serous ovarian cancer (HGSOC). Then, we narrow our focus on the advantages of using EV-mimetic nanoparticles as a delivery vehicle for RNAi therapy and other chemotherapeutics. Furthermore, we discuss the challenges of the clinical translation of engineering EV mimetic drug delivery systems and the promising directions of further development. Abstract High-grade serous ovarian cancer (HGSOC) is the most lethal gynecological malignancy among women. Several obstacles impede the early diagnosis and effective treatment options for ovarian cancer (OC) patients, which most importantly include the development of platinum-drug-resistant strains. Currently, extensive efforts are being put into the development of strategies capable of effectively circumventing the physical and biological barriers present in the peritoneal cavity of metastatic OC patients, representing a late stage of gastrointestinal and gynecological cancer with an extremely poor prognosis. Naturally occurring extracellular vesicles (EVs) have been shown to play a pivotal role in progression of OC and are now being harnessed as a delivery vehicle for cancer chemotherapeutics. However, there are limitations to their clinical application due to current challenges in their preparation techniques. Intriguingly, there is a recent drive towards the use of engineered synthetic EVs for the delivery of chemotherapeutics and RNA interference therapy (RNAi), as they show the promise of overcoming the obstacles in the treatment of OC patients. This review discusses the therapeutic application of EVs in OC and elucidates the potential use of engineered EV-mimetic nanoparticles as a delivery vehicle for RNAi therapy and other chemotherapeutics, which would potentially improve clinical outcomes of OC patients.
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Affiliation(s)
- Amal A. Al-Dossary
- Department of Basic Sciences, Deanship of Preparatory Year and Supporting Studies, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 34212, Saudi Arabia;
- Correspondence: ; Tel.: +966-1-333-31137
| | - Essam A. Tawfik
- National Center for Pharmaceutical Technology, Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442, Saudi Arabia; (E.A.T.); (A.A.A.); (F.A.A.); (A.M.A.)
| | - Adaugo C. Isichei
- Department of Basic Sciences, Deanship of Preparatory Year and Supporting Studies, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 34212, Saudi Arabia;
| | - Xin Sun
- Department of Bioengineering, Northeastern University, Boston, MA 02115, USA; (X.S.); (J.L.)
| | - Jiahe Li
- Department of Bioengineering, Northeastern University, Boston, MA 02115, USA; (X.S.); (J.L.)
| | - Abdullah A. Alshehri
- National Center for Pharmaceutical Technology, Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442, Saudi Arabia; (E.A.T.); (A.A.A.); (F.A.A.); (A.M.A.)
| | - Munther Alomari
- Department of Stem Cell Biology, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia;
| | - Fahad A. Almughem
- National Center for Pharmaceutical Technology, Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442, Saudi Arabia; (E.A.T.); (A.A.A.); (F.A.A.); (A.M.A.)
| | - Ahmad M. Aldossary
- National Center of Biotechnology, Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442, Saudi Arabia;
| | - Hussein Sabit
- Department of Genetics Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia;
| | - Abdulaziz M. Almalik
- National Center for Pharmaceutical Technology, Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442, Saudi Arabia; (E.A.T.); (A.A.A.); (F.A.A.); (A.M.A.)
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5
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Riedel M, Bronger H, Magdolen V, Dreyer T. The prognostic and diagnostic potential of kallikrein-related peptidases in ovarian cancer. Expert Rev Mol Diagn 2021; 21:535-545. [PMID: 33947310 DOI: 10.1080/14737159.2021.1924680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Introduction: Ovarian cancer is one of the deadliest malignancies among women worldwide. The lack of early diagnostic markers fuels an unfavorable prognosis as most patients are at an advanced stage when the disease is diagnosed for the first time. The role of the kallikrein-related peptidase (KLK) family in ovarian cancer progression and prognosis has been thoroughly investigated in various studies. Most of these peptidases are upregulated in ovarian cancer tissue compared to normal ovarian tissue and their expression is linked to overall and progression-free survival (OS/PFS). In this review, we address the clinical relevance of KLKs in ovarian cancer and their diagnostic potential.Areas covered: This review covers the expression and regulation of KLKs in ovarian cancer with focus on the prognostic and diagnostic potential, especially in liquid biopsies.Expert opinion: In ovarian cancer, several kallikrein-related peptidases are markedly expressed in a tissue-specific manner. Tumor-derived protease secretion results in elevated levels in serum and ascites. KLKs may thus serve as potential biomarkers alone or in combination with other serum tumor markers, such as Cancer Antigen 125 (CA125), for early detection and assessment of the prognosis of ovarian cancer patients.
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Affiliation(s)
- Maximilian Riedel
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
| | - Holger Bronger
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
| | - Viktor Magdolen
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
| | - Tobias Dreyer
- Department of Obstetrics and Gynecology, Technische Universität München, Munich, Germany
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6
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Wu Y, Wang C, Wang P, Wang C, Zhang Y, Han L. A high-performance microfluidic detection platform to conduct a novel multiple-biomarker panel for ovarian cancer screening. RSC Adv 2021; 11:8124-8133. [PMID: 35423342 PMCID: PMC8695074 DOI: 10.1039/d0ra10200h] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/30/2021] [Indexed: 11/22/2022] Open
Abstract
Ovarian cancer is an important leading cause of cancer-related deaths among females, and a single biomarker does not have the sensitivity and specificity required for an effective ovarian cancer screening. Herein, we investigate a high-performance microfluidic detection platform to conduct a novel panel of multiple biomarkers for the early detection of ovarian carcinoma, which include CA125, HE4, OPN, MSLN, Hsp70, CA153, AFP, IL-6, and IL-8 using a microfluidic chip. High-throughput microfluidic chips and graphene oxide-assembled substrate are used to microprint repeatable capture antibody arrays and conduct multiple biomarkers in microscale volume samples. The proposed microfluidic platform achieves an ultralow detection limit of ∼1 pg mL−1 and 0.01 U mL−1 with excellent detection selectivity and a short detection time of 30 min. The analysis of serum biomarkers in 18 ovarian cancer patients and 4 healthy persons indicates a clear subgroup sorting between the high-grade serous ovarian carcinoma, borderline, and benign tumor patients, and healthy persons. The proposed detection platform and the biomarker panel are promising to conduct an early detection of ovarian cancer. A high-performance microfluidic detection platform is developed to conduct a novel panel of multiple biomarkers for the early detection of ovarian carcinoma, which is promising for the early detection of ovarian cancer.![]()
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Affiliation(s)
- Yu Wu
- Peking University Third Hospital
- Beijing 100191
- China
| | - Chunhua Wang
- Institute of Marine Science and Technology
- Shandong University
- Qingdao 266273
- China
| | - Pan Wang
- Peking University Third Hospital
- Beijing 100191
- China
| | - Chao Wang
- Institute of Marine Science and Technology
- Shandong University
- Qingdao 266273
- China
| | - Yu Zhang
- Institute of Marine Science and Technology
- Shandong University
- Qingdao 266273
- China
| | - Lin Han
- Institute of Marine Science and Technology
- Shandong University
- Qingdao 266273
- China
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7
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Nasser NJ, Klein J, Agbarya A. Markers of Toxicity and Response to Radiation Therapy in Patients With Prostate Cancer. Adv Radiat Oncol 2021; 6:100603. [PMID: 33490732 PMCID: PMC7811126 DOI: 10.1016/j.adro.2020.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/05/2020] [Accepted: 10/17/2020] [Indexed: 02/07/2023] Open
Abstract
The main treatment modalities for localized prostate cancer are surgery and radiation. Surgery removes the whole prostate gland, whereas with radiation therapy the irradiated prostate remains within the patient's body. Biomarkers specific to the prostate gland should become undetectable after surgery, but this is not the case when radiation therapy is used, as residual prostate cells may still be metabolically active. Here, we review the role of tumor markers of toxicity and response to radiation therapy in patients with prostate cancer, including prostate specific antigen, human kallikrein 2, osteopontin, prostate cancer associated 3, citrulline, and others.
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Affiliation(s)
- Nicola J. Nasser
- Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Jonathan Klein
- Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Abed Agbarya
- Institute of Oncology, Bnai Zion Medical Center, Haifa, Israel
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8
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Hussein NH, Amin NS, El Tayebi HM. GPI-AP: Unraveling a New Class of Malignancy Mediators and Potential Immunotherapy Targets. Front Oncol 2020; 10:537311. [PMID: 33344222 PMCID: PMC7746843 DOI: 10.3389/fonc.2020.537311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 10/19/2020] [Indexed: 12/22/2022] Open
Abstract
With millions of cases diagnosed annually and high economic burden to cover expensive costs, cancer is one of the most difficult diseases to treat due to late diagnosis and severe adverse effects from conventional therapy. This creates an urgent need to find new targets for early diagnosis and therapy. Progress in research revealed the key steps of carcinogenesis. They are called cancer hallmarks. Zooming in, cancer hallmarks are characterized by ligands binding to their cognate receptor and so triggering signaling cascade within cell to make response for stimulus. Accordingly, understanding membrane topology is vital. In this review, we shall discuss one type of transmembrane proteins: Glycosylphosphatidylinositol-Anchored Proteins (GPI-APs), with specific emphasis on those involved in tumor cells by evading immune surveillance and future applications for diagnosis and immune targeted therapy.
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9
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Shinmura H, Yoneyama K, Harigane E, Tsunoda Y, Fukami T, Matsushima T, Takeshita T. Use of tumor markers to distinguish endometriosis-related ovarian neoplasms from ovarian endometrioma. Int J Gynecol Cancer 2020; 30:831-836. [PMID: 32354795 PMCID: PMC7362875 DOI: 10.1136/ijgc-2020-001210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022] Open
Abstract
Objective Only few studies have focused on tumor markers used in the preoperative diagnosis of endometriosis-related ovarian neoplasms, and previous studies have only assessed serum CA125 levels. This study investigated the significance of preoperative tumor markers and clinical characteristics in distinguishing endometriosis-related ovarian neoplasms from ovarian endometrioma. Methods A case-control study was conducted on 283 women who were diagnosed with confirmed pathology with endometriosis-related ovarian neoplasms (n=21) and ovarian endometrioma (n=262) at a single institution from April 2008 to April 2018. The serum CA125, CA19–9, carcinoembryogenic antigen (CEA), sialyl Lewis-x antigen (SLX), and lactate dehydrogenase (LDH) levels, age, tumor size, and the presence of mural nodule of the patients were analyzed. Results Patients with endometriosis-related ovarian neoplasms were more likely to be older (48 (range, 26–81) vs 39 (range, 22–68) years, P<0.001), have higher levels of CA19–9 (42 vs 19 U/mL, P=0.013), CEA (1.3 vs 0.84 ng/mL, P=0.007), SLX (41 vs 33 U/mL, P=0.050), and LDH (189 vs 166 U/mL, P<0.001) and larger tumor size (79 vs 55 mm, P=0.001), and present with mural nodule (85.7 vs 4.5 %, P<0.001) than those with ovarian endometrioma. The CA125 levels did not significantly differ between the two groups. The area under the curve for each factor was as follows: CA19-9 level, 0.672 (95% CI 0.52 to 0.83; P=0.013); CEA level, 0.725 (95% CI 0.58 to 0.87; P=0.007); SLX level, 0.670 (95% CI 0.53 to 0.84; P=0.050); LDH level, 0.800 (95% CI 0.70 to 0.90; P<0.001); age, 0.775 (95% CI 0.65 to 0.90; P<0.001); and tumor size, 0.709 (95% CI 0.56 to 0.86; P=0.001). Age was a better marker than CA19-9, CEA, and SLX levels according to the receiver operating characteristic curve analysis. The optimal cut-off values for age and tumor size were 47 years and 80 mm, respectively. Conclusions The assessment of serum CA19–9, CEA, SLX, and LDH levels may be a useful tool in the preoperative evaluation to differentiate between endometriosis-related ovarian neoplasms and ovarian endometrioma.
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Affiliation(s)
- Hiroki Shinmura
- Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki-shi, Japan
| | - Koichi Yoneyama
- Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki-shi, Japan
| | - Eika Harigane
- Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki-shi, Japan
| | - Yohei Tsunoda
- Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki-shi, Japan
| | - Takehiko Fukami
- Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki-shi, Japan
| | - Takashi Matsushima
- Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki-shi, Japan
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10
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Ziglioli F, Granelli G, Cavalieri D, Bocchialini T, Maestroni U. What chance do we have to decrease prostate cancer overdiagnosis and overtreatment? A narrative review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:423-426. [PMID: 31910165 PMCID: PMC7233784 DOI: 10.23750/abm.v90i4.9070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 11/23/2022]
Abstract
In the era of biochemical tests and algorithms, the management of prostate cancer from prevention to treatment is still controversial. The debate is focused on clinically-significant and clinically-insignificant prostate cancer. As it is well known, the diagnostic tools available are not able to distinguish between the two, thus leading to men treated for prostate cancer even if not strictly necessary. Unfortunately, as of today, there is no test available able to predict the clinical aggressiveness of prostate cancer at the time of the diagnosis. However, some indexes, PSA derivatives, immunocomplexes, and diagnostic methods have been proposed. If properly used in the daily clinical practice, these tools may be of support in the decision making process, in the effort to reduce the overdiagnosis and the overtreatment of prostate cancer.For this reason, we believe that a clear knowledge of this tools, indexes and diagnostic methods is of the utmost importance in preventing the morbidities related to unnecessary treatment as weel as preventing the detrimental effect of missing the diagnosis of a clinically significant prostate cancer.This reviews encompasses the most studied tests and diagnostic methods to predict the aggressiveness of prostate cancer, to avoid to miss a diagnosis of clinically significant cancers and to optimize the overall pre-treatment work-up. (www.actabiomedica.it).
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11
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Chandra A, Pius C, Nabeel M, Nair M, Vishwanatha JK, Ahmad S, Basha R. Ovarian cancer: Current status and strategies for improving therapeutic outcomes. Cancer Med 2019; 8:7018-7031. [PMID: 31560828 PMCID: PMC6853829 DOI: 10.1002/cam4.2560] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/22/2019] [Accepted: 08/24/2019] [Indexed: 12/14/2022] Open
Abstract
Of all the gynecologic tumors, ovarian cancer (OC) is known to be the deadliest. Advanced‐stages of OC are linked with high morbidity and low survival rates despite the immense amount of research in the field. Shortage of promising screening tools for early‐stage detection is one of the major challenges linked with the poor survival rate for patients with OC. In OC, therapeutic management is used with multidisciplinary approaches that includes debulking surgery, chemotherapy, and (rarely) radiotherapy. Recently, there is an increasing interest in using immunomodulation for treating OC. Relapse rates are high in this malignancy and averages around every 2‐years. Further treatments after the relapse are more intense, increasing the toxicity, resistance to chemotherapy drugs, and financial burden to patients with poor quality‐of‐life. A procedure that has been studied to help reduce the morbidity rate involves pre‐sensitizing cancer cells with standard therapy in order to produce optimal results with minimum dosage. Utilizing such an approach, platinum‐based agents are effective due to their increased response to platinum‐based chemotherapy in relapsed cases. These chemo‐drugs also help address the issue of drug resistance. After conducting an extensive search with available literature and the resources for clinical trials, information is precisely documented on current research, biomarkers, options for treatment and clinical trials. Several schemes for enhancing the therapeutic responses for OC are discussed systematically in this review with an attempt in summarizing the recent developments in this exciting field of translational/clinical research.
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Affiliation(s)
- Ashwin Chandra
- Texas College of Osteopathic Medicine, UNT Health Science Center, Fort Worth, TX, USA
| | - Cima Pius
- Miami Medical School, Miami, FL, USA
| | - Madiha Nabeel
- Graduate School of Biomedical Sciences, UNT Health Science Center, Fort Worth, TX, USA
| | - Maya Nair
- Graduate School of Biomedical Sciences, UNT Health Science Center, Fort Worth, TX, USA
| | - Jamboor K Vishwanatha
- Graduate School of Biomedical Sciences, UNT Health Science Center, Fort Worth, TX, USA
| | | | - Riyaz Basha
- Texas College of Osteopathic Medicine, UNT Health Science Center, Fort Worth, TX, USA.,Graduate School of Biomedical Sciences, UNT Health Science Center, Fort Worth, TX, USA
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12
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Plotti F, Guzzo F, Schirò T, Terranova C, De Cicco Nardone C, Montera R, Luvero D, Scaletta G, Lopez S, Capriglione S, Benedetti Panici P, Angioli R. Role of human epididymis protein 4 (HE4) in detecting recurrence in CA125 negative ovarian cancer patients. Int J Gynecol Cancer 2019; 29:ijgc-2019-000211. [PMID: 30992329 DOI: 10.1136/ijgc-2019-000211] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE There are no current guidelines regarding evaluation of patients with normal CA125 at initial diagnosis during routine surveillance after completion of treatment. Thus, the purpose of this study was to evaluate the role of human epididymis protein 4 (HE4) in the detection of recurrence in patients with ovarian cancer and a negative CA125 at diagnosis. METHODS All patients with ovarian cancer with a negative CA125 referred to the Division of Gynecologic Oncology of the University Campus Bio-Medico of Rome were included in the study. Inclusion criteria were: age between 18 and 70 years old, diagnosis of epithelial ovarian cancer, optimal primary surgery (residual tumor <1 cm), and normal CA125 at initial diagnosis. Patients with other malignancies or chronic diseases were excluded from the study. Statistical analysis was based on the calculation of percentages, means, medians, and ranges of the values. RESULTS A total of eight patients were included in the study. The median age was 53 years (range 40-75). All patients had a normal CA125 at initial diagnosis while seven (87.5%) patients had abnormal HE4 levels at diagnosis. The International Federation of Gynecology and Obstetrics (FIGO) stages at enrollment varied from IC to IIIC (IB (1), IC (3), IIC (1), IIIC (3)). The most common histologic subtype was serous (62.5%). Seven patients recurred and had abnormal HE4 and normal CA125 values. The median HE4 at recurrence was 107 pmol/L. The median disease-free interval was 55 months (range 5-108) and all the patients underwent optimal cytoreductive surgery. CONCLUSIONS HE4 levels may serve as a marker for recurrence in patients with a normal CA125 at initial diagnosis. Future studies are needed to evaluate the role of HE4 levels in earlier detection of recurrent ovarian cancer.
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Affiliation(s)
- Francesco Plotti
- Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy
| | - Federica Guzzo
- Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy
| | - Teresa Schirò
- Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy
| | - Corrado Terranova
- Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy
| | | | - Roberto Montera
- Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy
| | - Daniela Luvero
- Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy
| | - Giuseppe Scaletta
- Obstetrics and Gynecology, Gynecology Oncology Unit. Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy, Rome, Italy
| | - Salvatore Lopez
- Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy
| | - Stella Capriglione
- Università Campus Bio-Medico di Roma Facolta di Medicina e Chirurgia, Roma, Italy
| | | | - Roberto Angioli
- Obstetrics and Gynecology, Gynecology Oncology Unit. Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy, Rome, Italy
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Cerne K, Hadzialjevic B, Skof E, Verdenik I, Kobal B. Potential of osteopontin in the management of epithelial ovarian cancer. Radiol Oncol 2019; 53:105-115. [PMID: 30712025 PMCID: PMC6411016 DOI: 10.2478/raon-2019-0003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/27/2018] [Indexed: 02/07/2023] Open
Abstract
Background Osteopontin (sOPN) is a promising blood tumour marker for detecting epithelial ovarian cancer (EOC). However, other clinical uses of sOPN as a tumour marker in EOC are still lacking. Since sOPN concentrations in serum are not associated with those in ascites, we compared clinical value of sOPN concentrations in the two body fluids. Patients and methods The study included 31 women with advanced EOC and 34 women with benign gynaecological pathology. In the EOC group, serum for sOPN analysis was obtained preoperatively, after primary debulking surgery and after chemotherapy. In the control group, serum was obtained before and after surgery. Ascites and peritoneal fluid were obtained during surgery. sOPN concentrations were determined by flow cytometry bead-based assay. Results The sensitivity and specificity of sOPN in detecting EOC was 91.2% and 90.3% (cut-off = 47.4 ng/ml) in serum, and 96.8% and 100% (cut-off = 529.5 ng/ml) in ascites. Kaplan-Meier analysis showed a significant association between higher serum sOPN concentration and overall survival (p = 0.018) or progression free survival (p = 0.008). Higher ascites sOPN concentrations were associated with suboptimally debulked tumour and unresectable disease. Higher serum sOPN concentrations were associated with refractory disease or incomplete response to platinum-based chemotherapy. Conclusions The study showed that ascites sOPN level mirrors present disease and is superior to serum level for diagnostic purposes and surgical planning, although the end result of treatment is the response of the whole body in fighting the disease. The preoperative sOPN concentration in serum thus better reflects disease outcome.
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Affiliation(s)
- Katarina Cerne
- Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine, University Ljubljana, Ljubljana, Slovenia
| | - Benjamin Hadzialjevic
- Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine, University Ljubljana, Ljubljana, Slovenia
| | - Erik Skof
- Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Ivan Verdenik
- Department of Gynaecology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Department of Gynaecology and Obstetrics, Faculty of Medicine, University Ljubljana, Ljubljana, Slovenia
| | - Borut Kobal
- Department of Gynaecology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Department of Gynaecology and Obstetrics, Faculty of Medicine, University Ljubljana, Ljubljana, Slovenia
- Prof. Borut Kobal, M.D., Ph.D, Department of Gynaecology and Obstetrics, Faculty of Medicine, University Ljubljana, Šlajmarjeva 3, SI-1000 Ljubljana, Slovenia. Phone: +386 1 522 6060
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14
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Briggs MT, Condina MR, Klingler‐Hoffmann M, Arentz G, Everest‐Dass AV, Kaur G, Oehler MK, Packer NH, Hoffmann P. TranslatingN‐Glycan Analytical Applications into Clinical Strategies for Ovarian Cancer. Proteomics Clin Appl 2018; 13:e1800099. [DOI: 10.1002/prca.201800099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/30/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Matthew T. Briggs
- Adelaide Proteomics CentreSchool of Biological SciencesUniversity of Adelaide Adelaide 5005 Australia
- ARC Centre for Nanoscale BioPhotonics (CNBP)University of Adelaide Adelaide 5005 Australia
- Future Industries InstituteMawson Lakes CampusUniversity of South Australia 5095 Mawson Lakes
| | - Mark R. Condina
- Future Industries InstituteMawson Lakes CampusUniversity of South Australia 5095 Mawson Lakes
| | | | - Georgia Arentz
- Future Industries InstituteMawson Lakes CampusUniversity of South Australia 5095 Mawson Lakes
| | - Arun V. Everest‐Dass
- Institute for GlycomicsGold Coast CampusGriffith University Gold Coast 4215 Australia
- ARC Centre for Nanoscale BioPhotonics (CNBP)Macquarie University Sydney 2109 Australia
| | - Gurjeet Kaur
- Institute for Research in Molecular Medicine (INFORMM)Universiti Sains Malaysia Pulau Pinang Malaysia
| | - Martin K. Oehler
- Department of Gynaecological OncologyRoyal Adelaide Hospital Adelaide 5000 South Australia Australia
- Robinson InstituteUniversity of Adelaide Adelaide 5005 Australia
| | - Nicolle H. Packer
- Institute for GlycomicsGold Coast CampusGriffith University Gold Coast 4215 Australia
- ARC Centre for Nanoscale BioPhotonics (CNBP)Macquarie University Sydney 2109 Australia
| | - Peter Hoffmann
- Future Industries InstituteMawson Lakes CampusUniversity of South Australia 5095 Mawson Lakes
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15
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Fortner RT, Schock H, Le Cornet C, Hüsing A, Vitonis AF, Johnson TS, Fichorova RN, Fashemi T, Yamamoto HS, Tjønneland A, Hansen L, Overvad K, Boutron-Ruault MC, Kvaskoff M, Severi G, Boeing H, Trichopoulou A, Papatesta EM, Vecchia CL, Palli D, Sieri S, Tumino R, Sacerdote C, Mattiello A, Onland-Moret NC, Peeters PH, Bueno-de-Mesquita H, Weiderpass E, Quirós JR, Duell EJ, Sánchez MJ, Navarro C, Ardanaz E, Larrañaga N, Nodin B, Jirström K, Idahl A, Lundin E, Khaw KT, Travis RC, Gunter M, Johansson M, Dossus L, Merritt MA, Riboli E, Terry KL, Cramer DW, Kaaks R. Ovarian cancer early detection by circulating CA125 in the context of anti-CA125 autoantibody levels: Results from the EPIC cohort. Int J Cancer 2018; 142:1355-1360. [PMID: 29159934 PMCID: PMC5805613 DOI: 10.1002/ijc.31164] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/25/2017] [Accepted: 10/26/2017] [Indexed: 01/12/2023]
Abstract
CA125 is the best ovarian cancer early detection marker to date; however, sensitivity is limited and complementary markers are required to improve discrimination between ovarian cancer cases and non-cases. Anti-CA125 autoantibodies are observed in circulation. Our objective was to evaluate whether these antibodies (1) can serve as early detection markers, providing evidence of an immune response to a developing tumor, and (2) modify the discriminatory capacity of CA125 by either masking CA125 levels (resulting in lower discrimination) or acting synergistically to improve discrimination between cases and non-cases. We investigated these objectives using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort (EPIC) including 250 cases diagnosed within 4 years of blood collection and up to four matched controls. Circulating CA125 antigen and antibody levels were quantified using an electrochemiluminescence assay. Adjusted areas under the curve (aAUCs) by 2-year lag-time intervals were calculated using conditional logistic regression calibrated toward the absolute risk estimates from a pre-existing epidemiological risk model as an offset-variable. Anti-CA125 levels alone did not discriminate cases from controls. For cases diagnosed <2 years after blood collection, discrimination by CA125 antigen was suggestively higher with higher anti-CA125 levels (aAUC, highest antibody tertile: 0.84 [0.76-0.92]; lowest tertile: 0.76 [0.67-0.86]; phet = 0.06). We provide the first evidence of potentially synergistic discrimination effects of CA125 and anti-CA125 antibodies in ovarian early detection. If these findings are replicated, evaluating CA125 in the context of its antibody may improve ovarian cancer early detection.
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Affiliation(s)
- Renée T. Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Helena Schock
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Charlotte Le Cornet
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anika Hüsing
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Allison F. Vitonis
- Ob/Gyn Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts
| | - Theron S. Johnson
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Raina N. Fichorova
- Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
- Laboratory of Genital Tract Biology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Titilayo Fashemi
- Laboratory of Genital Tract Biology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Hidemi S. Yamamoto
- Laboratory of Genital Tract Biology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Anne Tjønneland
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Louise Hansen
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Marie-Christine Boutron-Ruault
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women’s Health team, F-94805, Villejuif, France
- Université Paris Sud, UMRS 1018, F-94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Marina Kvaskoff
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women’s Health team, F-94805, Villejuif, France
- Université Paris Sud, UMRS 1018, F-94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | - Gianluca Severi
- INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women’s Health team, F-94805, Villejuif, France
- Université Paris Sud, UMRS 1018, F-94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
- Human Genetics Foundation (HuGeF), Torino, Italy
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | | | - Carlo La Vecchia
- Hellenic Health Foundation, Athens, Greece
- Dept. of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic - M.P-Arezzo" Hospital, ASP Ragusa, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Amalia Mattiello
- Dipartimeno di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - N. Charlotte Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands
| | - Petra H. Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - H.B(as). Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | | | - Eric J Duell
- Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Carmen Navarro
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Navarra Public Health Institute, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Nerea Larrañaga
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Spain
| | - Björn Nodin
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Karin Jirström
- Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Eva Lundin
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Kay-Tee Khaw
- Cancer Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Ruth C. Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health University of Oxford, Oxford UK
| | - Marc Gunter
- International Agency for Research on Cancer, Lyon, France
| | | | - Laure Dossus
- International Agency for Research on Cancer, Lyon, France
| | - Melissa A. Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | - Kathryn L. Terry
- Ob/Gyn Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts
- Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
| | - Daniel W. Cramer
- Ob/Gyn Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts
- Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Madeira K, Dondossola ER, Farias BFDE, Simon CS, Alexandre MCM, Silva BR, Rosa MI. Mesothelin as a biomarker for ovarian carcinoma: a meta-analysis. AN ACAD BRAS CIENC 2018; 88:923-32. [PMID: 27254448 DOI: 10.1590/0001-3765201620150107] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 07/10/2015] [Indexed: 01/23/2023] Open
Abstract
The objective of this work was to estimate the accuracy of mesothelin as a biomarker for ovarian cancer. A quantitative systematic review was performed. A comprehensive search of the Medline, LILACS, SCOPUS, Embase, Cochrane Central Register of Controlled Trials, Biomed Central, and ISI Web of Science databases was conducted from January 1990 to June 2015. For inclusion in this systematic review, the papers must have measured mesothelin levels in at least two histological diagnoses; ovarian cancer (borderline or ovarian tumor) vs. benign or normal ovarian tissue. For each study, 2 x 2 contingency tables were constructed. We calculated the sensitivity, specificity and diagnostic odds ratio. The verification bias was performed according to QUADAS-2. Statistical analysis was performed with the software Stata 11, Meta-DiSc(r) and RevMan 5.2. Twelve studies were analyzed, which included 1,561 women. The pooled sensitivity was 0.62 (CI 95% 0.58 - 0.66) and specificity was 0.94 (CI 95% 0.92 - 0.95). The DOR was 38.92 (CI 95% 17.82 - 84.99). Our systematic review shows that mesothelin cannot serve alone as a biomarker for the detection of ovarian cancer.
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Affiliation(s)
- Kristian Madeira
- Laboratório de Epidemiologia, Bloco da Saúde, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, sala 26, Universitário, 88806-000 Criciúma, SC, Brasil, Universidade do Extremo Sul Catarinense, Universidade do Extremo Sul Catarinense, Criciúma SC , Brasil.,Programa de Pós-Graduação em Saúde Coletiva, Bloco da Saúde, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, sala 13, Universitário, 88806-000 Criciúma, SC, Brasil, Universidade do Extremo Sul Catarinense, Universidade do Extremo Sul Catarinense, Criciúma SC , Brasil
| | - Eduardo R Dondossola
- Laboratório de Epidemiologia, Bloco da Saúde, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, sala 26, Universitário, 88806-000 Criciúma, SC, Brasil, Universidade do Extremo Sul Catarinense, Universidade do Extremo Sul Catarinense, Criciúma SC , Brasil
| | - Bruna F DE Farias
- Laboratório de Epidemiologia, Bloco da Saúde, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, sala 26, Universitário, 88806-000 Criciúma, SC, Brasil, Universidade do Extremo Sul Catarinense, Universidade do Extremo Sul Catarinense, Criciúma SC , Brasil
| | - Carla S Simon
- Laboratório de Epidemiologia, Bloco da Saúde, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, sala 26, Universitário, 88806-000 Criciúma, SC, Brasil, Universidade do Extremo Sul Catarinense, Universidade do Extremo Sul Catarinense, Criciúma SC , Brasil
| | - Maria C M Alexandre
- Laboratório de Epidemiologia, Bloco da Saúde, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, sala 26, Universitário, 88806-000 Criciúma, SC, Brasil, Universidade do Extremo Sul Catarinense, Universidade do Extremo Sul Catarinense, Criciúma SC , Brasil
| | - Bruno R Silva
- Programa de Residência em Ginecologia e Obstetrícia, Hospital e Maternidade Marieta Konder Bornhausen, Av. Cel. Marcos Konder, 1111, Centro, 88301-303 Itajaí, SC, Brasil, Hospital e Maternidade Marieta Konder Bornhausen, Itajaí SC , Brasil
| | - Maria Inês Rosa
- Laboratório de Epidemiologia, Bloco da Saúde, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, sala 26, Universitário, 88806-000 Criciúma, SC, Brasil, Universidade do Extremo Sul Catarinense, Universidade do Extremo Sul Catarinense, Criciúma SC , Brasil.,Programa de Pós-Graduação em Saúde Coletiva, Bloco da Saúde, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, sala 13, Universitário, 88806-000 Criciúma, SC, Brasil, Universidade do Extremo Sul Catarinense, Universidade do Extremo Sul Catarinense, Criciúma SC , Brasil
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17
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Fortner RT, Damms-Machado A, Kaaks R. Systematic review: Tumor-associated antigen autoantibodies and ovarian cancer early detection. Gynecol Oncol 2017; 147:465-480. [PMID: 28800944 DOI: 10.1016/j.ygyno.2017.07.138] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Tumor-associated autoantibodies (AAbs), produced as an immune response to tumor-associated antigens (TAAs), are a novel pathway of early detection markers. METHODS We conducted a systematic review on AAbs and ovarian cancer to summarize the diagnostic performance of individual AAbs and AAb panels. A total of 29 studies including 85 AAbs were included; 27 of the studies were conducted in prevalent cases and cancer-free controls and 2 investigations included pre-diagnosis samples. The majority of studies were hypothesis-driven, evaluating AAbs to target TAAs; 10 studies used screening approaches such as serological expression cloning (SEREX) and nucleic acid-programmable protein arrays (NAPPA). RESULTS The highest sensitivities for individual AAbs were reported for RhoGDI-AAbs (89.5%) and TUBA1C-AAbs (89%); however, specificity levels were relatively low (80% and 75%, respectively). High sensitivities at high specificities were reported for HOXA7-AAbs for detection of moderately differentiated ovarian tumors (66.7% sensitivity at 100% specificity) and IL8-AAbs in stage I-II ovarian cancer (65.5% sensitivity at 98% specificity). A panel of 11 AAbs (ICAM3, CTAG2, p53, STYXL1, PVR, POMC, NUDT11, TRIM39, UHMK1, KSR1, and NXF3) provided 45% sensitivity at 98% specificity for serous ovarian cancer, when at least 2 AAbs were above a threshold of 95% specificity. Twelve of the AAbs identified in this review were investigated in more than one study. Data on diagnostic discrimination by tumor histology and stage at diagnosis are sparse. Limited data suggest select AAb markers improve diagnostic discrimination when combined with markers such as CA125 and HE4. CONCLUSIONS AAbs for ovarian cancer early detection is an emerging area, and large-scale, prospective investigations considering histology and stage are required for discovery and validation. However, data to date suggests panels of AAbs may eventually reach sufficient diagnostic discrimination to allow earlier detection of disease as a complement to existing markers and transvaginal ultrasound.
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Affiliation(s)
| | - Antje Damms-Machado
- Division of Cancer Epidemiology, German Cancer Research Center (DFKZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DFKZ), Heidelberg, Germany.
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Abstract
Osteopontin (OPN) is currently one of the most studied serum biomarkers of ovarian cancer (OC). This meta-analysis aims to ascertain whether OPN is a useful diagnostic biomarker for OC and determine the overall diagnostic accuracy of OPN measurement when combined with cancer antigen 125 (CA125). A systematic literature search was conducted in Cochrane Library, PubMed, EMBASE, CBM, and China National Knowledge Infrastructure databases. Information was independently extracted by two investigators. The Quality Assessment for Studies of Diagnostic Accuracy tool was applied to examine the quality of eligible studies, and a bivariate model was used to calculate the pooled estimates. We identified 17 and 10 studies that evaluated the role of OPN alone and OPN combined with CA125 in diagnosing ovarian tumor, respectively. The overall diagnostic sensitivity and specificity of OPN in OC were 0.766 (95% CI 0.685-0.831) and 0.897 (95% CI 0.849-0.931), correspondingly. When OPN was combined with CA125, the sensitivity and specificity were 0.871 (95% CI 0.788-0.924) and 0.881 (95% CI 0.837-0.914), respectively. OPN is a useful tumor biomarker in future screening tests of OC and can be a promising adjunct to CA125. Additional studies with multicenter trials and carefully selected controls are needed to further verify the results.
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Diagnostic Accuracy of Serum Kallikrein-Related Peptidases for Ovarian Cancer: A Systematic Review and Meta-Analysis. Int J Gynecol Cancer 2016; 26:1366-74. [PMID: 27465901 DOI: 10.1097/igc.0000000000000781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE At present, considerable efforts have been made to identify new cancer-specific markers for ovarian cancer (OC) diagnosis and the kallikrein-related peptidases (KLKs) family is one of the most studied candidates. This meta-analysis aims to evaluate the pooled diagnostic value of serum KLK measurement for diagnosing OC. METHODS The Cochrane Library, PubMed, Excerpt Medica Database were searched for all relevant literature. The Quality Assessment for Studies of Diagnostic Accuracy tool was applied to assess the quality of enrolled studies. Statistical analysis was conducted by using Stata 13.0 software and Meta-Disc. RESULTS A total of 15 studies from 13 articles were considered eligible for inclusion in the present analysis. The following pooled parameters were calculated by using the bivariate model: sensitivity of 0.582 (95% confidence interval [CI], 0.517-0.644), specificity of 0.909 (95% CI, 0.833-0.952), positive likelihood ratios of 6.367 (95% CI, 3.330-12.172), negative likelihood ratios of 0.460 (95% CI, 0.388-0.546), diagnostic odds ratio of 13.831 (95% CI, 6.460-29.614), respectively. CONCLUSIONS Kallikrein-related peptidase seems to be a promising candidate biomarker in diagnosing OC, but the associated poor sensitivity of KLK individually may limit its value in clinical application. To resolve this problem, the combination of KLK and other markers may offer improved performance than a single marker.
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Wang Y, Sundfeldt K, Mateoiu C, Shih IM, Kurman RJ, Schaefer J, Silliman N, Kinde I, Springer S, Foote M, Kristjansdottir B, James N, Kinzler KW, Papadopoulos N, Diaz LA, Vogelstein B. Diagnostic potential of tumor DNA from ovarian cyst fluid. eLife 2016; 5. [PMID: 27421040 PMCID: PMC4946896 DOI: 10.7554/elife.15175] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 06/13/2016] [Indexed: 12/11/2022] Open
Abstract
We determined whether the mutations found in ovarian cancers could be identified in the patients' ovarian cyst fluids. Tumor-specific mutations were detectable in the cyst fluids of 19 of 23 (83%) borderline tumors, 10 of 13 (77%) type I cancers, and 18 of 18 (100%) type II cancers. In contrast, no mutations were found in the cyst fluids of 18 patients with benign tumors or non-neoplastic cysts. Though large, prospective studies are needed to demonstrate the safety and clinical utility of this approach, our results suggest that the genetic evaluation of cyst fluids might be able to inform the management of the large number of women with these lesions. DOI:http://dx.doi.org/10.7554/eLife.15175.001 More than a third of women develop ovarian cysts during their lifetimes. The vast majority of these cysts are harmless, but a small number are caused by ovarian cancers. These cancers often produce no symptoms until the disease has spread throughout the abdomen or to other organs, so many women go undiagnosed until their chances of being successfully treated are low. Currently, there is no reliable way to determine whether an ovarian cyst is cancerous without performing surgery. As a result, many women undergo unnecessary, invasive surgeries for harmless ovarian cysts. Tumors shed cells and cell fragments into any fluid that surrounds them. Fluids from cysts in the pancreas, kidney, and thyroid are routinely examined to identify whether they contain cancerous cells. Now, Wang, Sundfeldt et al. show that ovarian cancers also shed DNA into the surrounding cyst fluid. Furthermore, mutations found in this DNA can provide valuable information about whether the cysts are cancerous. The study was performed by extracting DNA from the fluid in ovarian cysts that had been surgically removed from 77 women. Of these cysts, 10 were harmless cysts, 12 were benign tumors, 31 were invasive cancers, and 24 were so-called borderline tumors, which fall somewhere between the benign tumors and invasive cancers. Only cysts associated with the borderline tumors and invasive cancers need to be surgically removed. Here, Wang, Sundfeldt et al. report that DNA mutations that are characteristic of ovarian cancers were found in 87% of the cysts associated with borderline tumors and invasive cancers. In contrast, these mutations were not found in any of the cysts that do not require surgery. Fluid can be extracted from an ovarian cyst with a needle during an outpatient visit. Therefore, the results presented by Wang, Sundfeldt et al. suggest a relatively straightforward way of testing the DNA from ovarian cysts before deciding whether surgery is really necessary. First, however, larger studies that follow women with cysts over time will be necessary to confirm that this type of testing is effective and safe. DOI:http://dx.doi.org/10.7554/eLife.15175.002
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Affiliation(s)
- Yuxuan Wang
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - Constantina Mateoiu
- Department of Pathology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Ie-Ming Shih
- Department of Pathology, The Johns Hopkins Medical Institutes, Baltimore, United States.,Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, United States
| | - Robert J Kurman
- Department of Pathology, The Johns Hopkins Medical Institutes, Baltimore, United States.,Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, United States
| | - Joy Schaefer
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States
| | - Natalie Silliman
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States
| | - Isaac Kinde
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States
| | - Simeon Springer
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States
| | - Michael Foote
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Swim Across America Laboratory, Baltimore, United States
| | - Björg Kristjansdottir
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - Nathan James
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States
| | - Kenneth W Kinzler
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States
| | - Nickolas Papadopoulos
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States
| | - Luis A Diaz
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Swim Across America Laboratory, Baltimore, United States
| | - Bert Vogelstein
- Ludwig Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States.,Sidney Kimmel Comprehensive Cancer Center, Howard Hughes Medical Institute, Johns Hopkins University, Baltimore, United States
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Yang F, Hu ZDE, Chen Y, Hu CJ. Diagnostic value of KLK6 as an ovarian cancer biomarker: A meta-analysis. Biomed Rep 2016; 4:681-686. [PMID: 27284406 PMCID: PMC4887959 DOI: 10.3892/br.2016.662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/05/2016] [Indexed: 01/29/2023] Open
Abstract
Kallikrein-related peptidase 6 (KLK6) is a new potential serum biomarker of ovarian cancer. The aim of the present study was to assess the diagnostic value of KLK6 systematically for ovarian cancer. All the selected studies regarding the changes of KLK6 in ovarian cancer were published prior to April 2015. Five studies involving 485 patients with ovarian cancer, 420 benign cysts and 245 healthy controls met the inclusion criteria. The value of sensitivity, specificity, positive-likelihood ratio (LR+), negative-likelihood ratio (LR-) and area under the receiver operating characteristic curve (ROC) were obtained. All these indices were used to evaluate the diagnostic value of KLK6 for ovarian cancer. The values of sensitivity, specificity, LR+ and LR- (95% confidence interval) of KLK6 were 0.50 (0.47–0.54), 0.91 (0.89–0.93), 7.20 (3.34–15.52) and 0.51 (0.43–0.62), respectively. The area under the summary ROC of KLK6 was 0.86. The index of Q* was 0.79. In conclusion, KLK6 showed high specificity for the diagnosis of ovarian cancer. It can improve the diagnostic accuracy of cancer antigen 125 (CA125). A combined panel of CA125 and KL K6 shows a high diagnostic efficiency for advanced ovarian cancer. Owing to the small number of studies and lack of samples, additional studies meeting the inclusion criteria are required to further analyze the diagnostic value of KLK6 for ovarian cancer.
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Affiliation(s)
- Fan Yang
- Graduate School of Jinzhou Medical University, Jinzhou, Liaoning 121001, P.R. China
| | - Zhi-DE Hu
- Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan, Shandong 250031, P.R. China
| | - Yingjian Chen
- Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan, Shandong 250031, P.R. China
| | - Cheng-Jin Hu
- Department of Laboratory Medicine, General Hospital of Ji'nan Military Command Region, Ji'nan, Shandong 250031, P.R. China
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Involvement of Kallikrein-Related Peptidases in Normal and Pathologic Processes. DISEASE MARKERS 2015; 2015:946572. [PMID: 26783378 PMCID: PMC4689925 DOI: 10.1155/2015/946572] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/16/2015] [Accepted: 10/29/2015] [Indexed: 12/31/2022]
Abstract
Human kallikrein-related peptidases (KLKs) are a subgroup of serine proteases that participate in proteolytic pathways and control protein levels in normal physiology as well as in several pathological conditions. Their complex network of stimulatory and inhibitory interactions may induce inflammatory and immune responses and contribute to the neoplastic phenotype through the regulation of several cellular processes, such as proliferation, survival, migration, and invasion. This family of proteases, which includes one of the most useful cancer biomarkers, kallikrein-related peptidase 3 or PSA, also has a protective effect against cancer promoting apoptosis or counteracting angiogenesis and cell proliferation. Therefore, they represent attractive therapeutic targets and may have important applications in clinical oncology. Despite being intensively studied, many gaps in our knowledge on several molecular aspects of KLK functions still exist. This review aims to summarize recent data on their involvement in different processes related to health and disease, in particular those directly or indirectly linked to the neoplastic process.
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Shi JX, Qin JJ, Ye H, Wang P, Wang KJ, Zhang JY. Tumor associated antigens or anti-TAA autoantibodies as biomarkers in the diagnosis of ovarian cancer: a systematic review with meta-analysis. Expert Rev Mol Diagn 2015; 15:829-52. [PMID: 25959246 DOI: 10.1586/14737159.2015.1035713] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Jian-Xiang Shi
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
- 3Department of Biological Sciences, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA
| | - Jie-Jie Qin
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Hua Ye
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Peng Wang
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Kai-Juan Wang
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Jian-Ying Zhang
- 1Department of Epidemiology, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- 2Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
- 3Department of Biological Sciences, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA
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Hu ZD, Wei TT, Yang M, Ma N, Tang QQ, Qin BD, Fu HT, Zhong RQ. Diagnostic value of osteopontin in ovarian cancer: a meta-analysis and systematic review. PLoS One 2015; 10:e0126444. [PMID: 25951060 PMCID: PMC4423864 DOI: 10.1371/journal.pone.0126444] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/02/2015] [Indexed: 11/19/2022] Open
Abstract
AIMS Osteopontin (OPN) plays an important role in many physiological and pathological processes (wound healing, inflammation, immune response, and tumorigenesis). This meta-analysis assessed the diagnostic value of osteopontin in ovarian cancer. METHODS AND RESULTS Searches in Embase and PubMed were conducted, in order to identify eligible studies on osteopontin expression and its diagnostic value in ovarian cancer. The revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tool was applied to examine the quality of these studies and the overall osteopontin diagnostic accuracy in ovarian cancer was pooled using the bivariate model. The publication bias was assessed using funnel plots and Deek's test. This search methodology resulted in 13 studies with a total of 839 ovarian cancer patients and 1439 controls in this meta-analysis. The overall osteopontin diagnostic sensitivity and specificity of ovarian cancer were 0.66 (95% CI, 0.51-0.78) and 0.88 (95% CI, 0.78-0.93), respectively. The area under summary receiver operating characteristic (sROC) curves (AUC) was 0.85 (95%CI, 0.81-0.88). There was no significant publication bias observed across the eligible studies. However, a major design deficiency of the eligible studies is the issue of subject selection bias. CONCLUSIONS Osteopontin could be a useful biomarker in diagnosis of ovarian cancer. Due to the design deficits of the eligible studies, a future study with a larger sample size and better design is needed to rigorously confirm the diagnostic potential of osteopontin in ovarian cancer.
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Affiliation(s)
- Zhi-De Hu
- Department of Laboratory Diagnostics, Changzheng Hospital, The Second Military Medical University, Shanghai, China
- Department of Laboratory Medicine, The General Hospital, Ji’nan Military Region of PLA, Ji’nan, Shandong, China
| | - Ting-Ting Wei
- Department of Laboratory Diagnostics, Changzheng Hospital, The Second Military Medical University, Shanghai, China
| | - Min Yang
- Department of Laboratory Diagnostics, Changzheng Hospital, The Second Military Medical University, Shanghai, China
| | - Ning Ma
- Department of Laboratory Diagnostics, Changzheng Hospital, The Second Military Medical University, Shanghai, China
| | - Qing-Qin Tang
- Department of Laboratory Diagnostics, Changzheng Hospital, The Second Military Medical University, Shanghai, China
| | - Bao-Dong Qin
- Department of Laboratory Diagnostics, Changzheng Hospital, The Second Military Medical University, Shanghai, China
| | - Hai-Tao Fu
- Department of Laboratory Diagnostics, Changzheng Hospital, The Second Military Medical University, Shanghai, China
| | - Ren-Qian Zhong
- Department of Laboratory Diagnostics, Changzheng Hospital, The Second Military Medical University, Shanghai, China
- * E-mail:
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Tamir A, Jag U, Sarojini S, Schindewolf C, Tanaka T, Gharbaran R, Patel H, Sood A, Hu W, Patwa R, Blake P, Chirina P, Oh Jeong J, Lim H, Goy A, Pecora A, Suh KS. Kallikrein family proteases KLK6 and KLK7 are potential early detection and diagnostic biomarkers for serous and papillary serous ovarian cancer subtypes. J Ovarian Res 2014; 7:109. [PMID: 25477184 PMCID: PMC4271347 DOI: 10.1186/s13048-014-0109-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 11/11/2014] [Indexed: 12/13/2022] Open
Abstract
Background Early detection of ovarian cancer remains a challenge due to widespread metastases and a lack of biomarkers for early-stage disease. This study was conducted to identify relevant biomarkers for both laparoscopic and serum diagnostics in ovarian cancer. Methods Bioinformatics analysis and expression screening in ovarian cancer cell lines were employed. Selected biomarkers were further validated in bio-specimens of diverse cancer types and ovarian cancer subtypes. For non-invasive detection, biomarker proteins were evaluated in serum samples from ovarian cancer patients. Results Two kallikrein (KLK) serine protease family members (KLK6 and KLK7) were found to be significantly overexpressed relative to normal controls in most of the ovarian cancer cell lines examined. Overexpression of KLK6 and KLK7 mRNA was specific to ovarian cancer, in particular to serous and papillary serous subtypes. In situ hybridization and histopathology further confirmed significantly elevated levels of KLK6 and KLK7 mRNA and proteins in tissue epithelium and a lack of expression in neighboring stroma. Lastly, KLK6 and KLK7 protein levels were significantly elevated in serum samples from serous and papillary serous subtypes in the early stages of ovarian cancer, and therefore could potentially decrease the high “false negative” rates found in the same patients with the common ovarian cancer biomarkers human epididymis protein 4 (HE4) and cancer antigen 125 (CA-125). Conclusion KLK6 and KLK7 mRNA and protein overexpression is directly associated with early-stage ovarian tumors and can be measured in patient tissue and serum samples. Assays based on KLK6 and KLK7 expression may provide specific and sensitive information for early detection of ovarian cancer. Electronic supplementary material The online version of this article (doi:10.1186/s13048-014-0109-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ayala Tamir
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Ushma Jag
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Sreeja Sarojini
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Craig Schindewolf
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Takemi Tanaka
- Thomas Jefferson University, Philadelphia, PA, 19107, USA.
| | - Rajendra Gharbaran
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Hiren Patel
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Anil Sood
- Departments of Gynecologic Oncology and Cancer Biology, MD Anderson Cancer Center, University of Texas, Houston, TX, 77030, USA.
| | - Wei Hu
- Departments of Gynecologic Oncology and Cancer Biology, MD Anderson Cancer Center, University of Texas, Houston, TX, 77030, USA.
| | - Ruzeen Patwa
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Patrick Blake
- Sophic Systems Alliance, Inc, Rockville, MD, 20850, USA.
| | - Polina Chirina
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Jin Oh Jeong
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Heejin Lim
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Andre Goy
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - Andrew Pecora
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
| | - K Stephen Suh
- The Genomics and Biomarkers Program, The John Theurer Cancer Center, Hackensack University Medical Center, D. Jurist Research Building, 40 Prospect Avenue, Hackensack, NJ, 07601, USA.
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Correlation between ovarian neoplasm and serum levels of osteopontin: a meta-analysis. Tumour Biol 2014; 35:11799-808. [PMID: 25192720 DOI: 10.1007/s13277-014-2314-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 07/04/2014] [Indexed: 01/11/2023] Open
Abstract
The aim of this meta-analysis was to evaluate the clinical significance of serum osteopontin (OPN) levels in ovarian neoplasm in patients, with the goal of building a novel diagnostic score model. By searching the PubMed, Embase, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, CBM, and China National Knowledge Infrastructure (CNKI) databases, we conducted a meta-analysis. Studies were pooled, and the standardized mean difference (SMD) and its corresponding 95 % confidence interval (CI) were calculated. Subgroup analyses and publication bias detection were also conducted. Version 12.0 STATA software was used for statistical analysis. We performed a final analysis of 1,653 subjects altogether (822 patients with psoriasis and 831 healthy controls) from 15 clinical case-control studies. The meta-analysis results showed a positive association between serum OPN levels and ovarian neoplasm (SMD = 2.60, 95 %CI 1.88-3.32, P < 0.001). The subgroup analysis by ethnicity detected that high levels of serum OPN may be the main risk factor for ovarian neoplasms in Asians (SMD = 2.91, 95 %CI 2.38-3.45, P < 0.001), but not in Caucasians (P > 0.05). The present meta-analysis indicated that serum OPN levels were generally elevated in ovarian neoplasm patients, and thus, serum levels of OPN could be useful in diagnosing ovarian neoplasm.
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