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Bandiera E, Zanotti L, Fabricio ASC, Bucca E, Squarcina E, Romani C, Tassi R, Bignotti E, Todeschini P, Tognon G, Romagnolo C, Gion M, Sartori E, Maggino T, Pecorelli S, Ravaggi A. Cancer antigen 125, human epididymis 4, kallikrein 6, osteopontin and soluble mesothelin-related peptide immunocomplexed with immunoglobulin M in epithelial ovarian cancer diagnosis. Clin Chem Lab Med 2014; 51:1815-24. [PMID: 24013103 DOI: 10.1515/cclm-2013-0151] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 07/29/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Human epididymis protein 4 (HE4), kallikrein 6 (KLK6), osteopontin (OPN) and soluble mesothelin-related peptide (SMRP) are new promising biomarkers that could integrate CA125 in epithelial ovarian cancer (EOC) diagnosis. The autoantibody response to tumor antigens is a potential tool for improving the diagnostic performances of biomarkers. The aim of this study was to assess the diagnostic potential of these biomarkers in the form of free markers and immunocomplexed with immunoglobulin M (IgM). Moreover, we analyzed the association between these markers and clinico-pathological characteristics of EOC patients. METHODS Serum and plasma samples of 60 healthy controls, 60 ovarian benign cysts, 60 endometriosis and 60 EOCs, collected before any treatment, were tested for CICs and free antigens by immunoassays. RESULTS Immunocomplexes were characterized by poor sensitivity and specificity, since they allowed the detection only of a small number of EOC patients and were increased in patients with benign gynecological pathologies. However, the markers in the form of free antigens showed good diagnostic performances. Of note, CA125 and HE4 showed high sensitivity in the detection of the malignancy and HE4 emerged as a useful biomarker in differential diagnosis between EOC and endometriosis. Finally, elevated KLK6 and OPN, were associated with advanced FIGO stage, high grade disease, suboptimally debulked tumor and ascites. CONCLUSIONS This study confirms the diagnostic role of CA125, HE4, KLK6, OPN and SMRP, and for the first time showed that CA125, HE4, KLK6, OPN and SMRP immunocomplexed with IgM are not a potential tool for EOC diagnosis.
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Pini S, Di Fabio F, Di Tullio P, Bucca E, Latiano T, Perrone E, Gion M, Maiello E, Martoni A, Pinto C. Evaluation of serum/plasma VEGF/e-selectin and 18F-FDG PET uptake after panitumumab infusion in locally advanced rectal cancer (LARC) patients treated with chemoradiation (CTRT) (StarPan/STAR-02 phase II study). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bucca E, Beneduce L, Leon AE, Fabricio AS, Michilin S, Meo S, Vitale MP, Steffan A, Durante C, Belluco C, Rizzo A, Berlanda G, Perasole A, Zampieri F, Zuin J, Veggiani G, Fassina G, Gion M. The Usefulness of the Combination of Free CA 15.3 and CA 15.3-IGM Complexes for Breast Cancer Diagnosis. Int J Biol Markers 2009. [DOI: 10.1177/172460080902400319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Several studies have shown that the main circulating biomarkers of liver and colorectal cancer can be detected in the bloodstream and are also associated with immunoglobulin M to form stable complexes. These immune complexes show increased capacity of discrimination between cancer patients and healthy controls if combined with the free biomarker form. Within the context of the Project FIRB 2003 - Nanosized Cancer Polymarker Biochip - we wanted to investigate if IgM complexes have importance also in breast cancer. We focused our study on the immune complexes between IgM and CA 15.3 because free CA 15.3 is the most commonly used breast cancer biomarker in clinical practice. However, this biomarker alone lacks satisfactory sensitivity especially in early cancer detection. Aim The aim of our study was to assess the occurrence of immune complexes between CA 15.3 and IgM in sera from patients with primary breast cancer and in sera from healthy controls to evaluate its putative diagnostic value compared with the diagnostic value of free CA 15.3. Methods A total of 130 serum samples were obtained from 56 healthy women (mean age±SD, 45±8.23 years) and 74 women with stage l and II breast cancer (mean age±SD, 59±13.6 years) before any treatment, either surgical or chemo-therapeutic. Serum samples were collected, aliquoted and stored at-80°C in the centralized biobank of the project according to very stringent standard operating procedures (SOPs) distributed by the coordinating unit. To evaluate the presence of CA 15.3-lgM immune complexes, we developed and validated a novel enzyme-linked immunosorbent assay (ELISA) with a polyclonal rabbit anti-human CA 15.3 antibody (Abcam) as the catcher antibody. CA 15.3-lgM was detected with peroxidase-conjugated anti-human IgM and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and hydrogen peroxide as substrate (Sigma Aldrich, Italy). The levels of CA 15.3-lgM were expressed in arbitrary units per mL (AU/mL) by interpolation on a calibration curve obtained by serial dilution of a reference calibrator purified by gel filtration chromatography from a pool of serum samples with high levels of CA 15.3-lgM. Serum levels of free CA 15.3 were assessed in parallel on each sample using an automated immunoassay system (ADVIA Centaur-Siemens Diagnostics) and expressed in U/mL. Results To discriminate between cancer patients and healthy controls, we used as cutoff values 31.5 U/mL for free CA 15.3 (corresponding to the cutoff used in the clinical routine) and 794 AU/mL for CA 15.3-lgM (representing the 95th percentile of the distribution of serum levels of CA 15.3-lgM in healthy controls). By using these cutoff values, we obtained a sensitivity of 1 0% (7/74 cases) and a specificity of 95% (53/56 controls) for CA 15.3-lgM. The sensitivity and specificity of free CA15.3 were 7% (5/74 cases) and 1 00% (56/56 controls), respectively. Interestingly, the serum levels of the two biomarkers did not overlap, so their combination at 95% specificity identified 12/74 cases (16.2%). When we took a cutoff of 22 U/ mL for free CA15.3 (the 95th percentile of its distribution in healthy controls), we calculated a sensitivity of 26% (1 9/74 cases) and a specificity of 95% (53/56 controls); its combination with CA 15.3-lgM had a sensitivity of 34% (25/74 cases) and a specificity of 90% (50/56 controls). Conclusions These results demonstrate for the first time the presence of CA 15.3-lgM in the bloodstream of patients with breast cancer. In addition, our data suggest that CA 15.3-lgM is a complementary serological marker to free CA 15.3 and the combination of these biomarkers could improve the diagnosis of breast cancer.
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Affiliation(s)
- Elisa Bucca
- ABO Association, Regional Center for the Study of Biological Markers of Malignancy, AULSS 12, Venice
| | | | - Antonette E. Leon
- ABO Association, Regional Center for the Study of Biological Markers of Malignancy, AULSS 12, Venice
| | - Aline S.C. Fabricio
- ABO Association, Regional Center for the Study of Biological Markers of Malignancy, AULSS 12, Venice
| | - Silvia Michilin
- ABO Association, Regional Center for the Study of Biological Markers of Malignancy, AULSS 12, Venice
| | - Sabrina Meo
- ABO Association, Regional Center for the Study of Biological Markers of Malignancy, AULSS 12, Venice
| | - Maria Pia Vitale
- ABO Association, Regional Center for the Study of Biological Markers of Malignancy, AULSS 12, Venice
| | - Agostino Steffan
- Department of Laboratory Medicine, CRO IRCCS, national Cancer Institute, Aviano
| | - Cristina Durante
- Department of Laboratory Medicine, CRO IRCCS, national Cancer Institute, Aviano
| | - Claudio Belluco
- Department of Surgery, CRO IRCCS, national Cancer Institute, Aviano
| | - Antonio Rizzo
- Department of Anatomic Pathology, Castelfranco Veneto City Hospital, AULSS 8, Castelfranco Veneto
| | - Giuseppe Berlanda
- Department of Surgery, Castelfranco Veneto City Hospital, AULSS 8, Castelfranco Veneto
| | - Antonio Perasole
- Department of Anatomic Pathology, Castelfranco Veneto City Hospital, AULSS 8, Castelfranco Veneto
| | | | | | | | | | - Massimo Gion
- ABO Association, Regional Center for the Study of Biological Markers of Malignancy, Department of Clinical pathology, AULSS 12, Venice - Italy
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Di Fabio F, Pinto C, Bucca E, Giaquinta S, Fabricio AS, Mutri V, Michilin S, Llimpe FLR, Funaioli C, Gion M, Martoni AA. Predictive value of circulating VEGF in patients with advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma treated with cetuximab in combination with cisplatin and docetaxel (Italian phase II DOCETUX Study). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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