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Assessment of protein biomarkers for preoperative differential diagnosis between benign and malignant ovarian tumors
- Source :
- Gynecologic Oncology. 159:811-819
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Objective To estimate the diagnostic value of tumor and immune related proteins in the discrimination between benign and malignant adnexal masses, and between different subgroups of tumors. Methods In this exploratory diagnostic study, 254 patients with an adnexal mass scheduled for surgery were consecutively enrolled at the University Hospitals Leuven (128 benign, 42 borderline, 22 stage I, 55 stage II-IV, and 7 secondary metastatic tumors). The quantification of 33 serum proteins was done preoperatively, using multiplex high throughput immunoassays (Luminex) and electrochemiluminescence immuno-assay (ECLIA). We calculated univariable areas under the Receiver Operating Characteristic Curves (AUCs). To discriminate malignant from benign tumors, multivariable ridge logistic regression with backward elimination was performed, using bootstrapping to validate the resulting AUCs. Results CA125 had the highest univariable AUC to discriminate malignant from benign tumors (0.85, 95% confidence interval 0.79-0.89). Combining CA125 with CA72.4 and HE4 increased the AUC to 0.87. For benign vs borderline tumors, CA125 had the highest univariable AUC (0.74). For borderline vs stage I malignancy, no proteins were promising. For stage I vs II-IV malignancy, CA125, HE4, CA72.4, CA15.3 and LAP had univariable AUCs ≥0.80. Conclusions The results confirm the dominant role of CA125 for identifying malignancy, and suggest that other markers (HE4, CA72.4, CA15.3 and LAP) may help to distinguish between stage I and stage II-IV malignancies. However, further research is needed, also to investigate the added value over clinical and ultrasound predictors of malignancy, focusing on the differentiation between subtypes of malignancy.
- Subjects :
- Adult
0301 basic medicine
Oncology
medicine.medical_specialty
Adolescent
Malignancy
Logistic regression
Adnexal mass
Diagnosis, Differential
Young Adult
03 medical and health sciences
WAP Four-Disulfide Core Domain Protein 2
0302 clinical medicine
Internal medicine
Humans
Medicine
Antigens, Tumor-Associated, Carbohydrate
Prospective Studies
Stage (cooking)
Aged
Neoplasm Staging
Aged, 80 and over
Ovarian Neoplasms
Receiver operating characteristic
business.industry
Ovary
Membrane Proteins
Obstetrics and Gynecology
Middle Aged
medicine.disease
Confidence interval
030104 developmental biology
ROC Curve
CA-125 Antigen
030220 oncology & carcinogenesis
Preoperative Period
Female
Differential diagnosis
business
Ovarian cancer
Subjects
Details
- ISSN :
- 00908258
- Volume :
- 159
- Database :
- OpenAIRE
- Journal :
- Gynecologic Oncology
- Accession number :
- edsair.doi.dedup.....54e768296c357a4269a4b975cfe1beb4