Serum biomarker panels for the discrimination of benign from malignant cases in patients with an adnexal mass

Brian Nolen, Liudmila Velikokhatnaya, Adele Marrangoni, Koen De Geest, Aleksey Lomakin, Robert C. Bast, Anna Lokshin

Research output: Contribution to journalArticle

117 Scopus citations

Abstract

Objectives.: The diagnosis of an adnexal mass is a prevalent issue among women in the United States, although current methods of identifying those at high risk of malignancy remain insufficient. Ineffective triage of women with malignant masses is associated with delayed or inappropriate treatment and a negative effect on disease outcome. Methods.: We performed an evaluation of 65 ovarian cancer-related biomarkers in the circulation of women diagnosed with an adnexal mass. Our subject group consisted of women diagnosed with benign masses and early- and late-stage ovarian cancer. Results.: More than half of the biomarkers tested were found to differ significantly between benign and malignant cases. As individual markers, HE4 and CA-125 provided the greatest level of discrimination between benign and malignant cases, and the combination of these two biomarkers provided a higher level of discriminatory power than either marker considered alone. Multivariate statistical analysis identified several multimarker panels that could discriminate early-stage, late-stage, and combined ovarian cancers from benign cases with similar or slightly improved SN/SP levels to the CA-125/HE4 combination; however, these larger panels could not outperform the 2-biomarker panel in an independent validation set. We also identified a 3-biomarker panel with particular utility in premenopausal women. Conclusions.: Our findings serve to advance the development of blood-based screening methods for the discrimination of benign and malignant ovarian masses by confirming and expanding upon the superior utility of the CA-125/HE4 combination.

Original languageEnglish (US)
Pages (from-to)440-445
Number of pages6
JournalGynecologic oncology
Volume117
Issue number3
DOIs
StatePublished - Jun 2010

Keywords

  • Adnexal mass
  • CA-125
  • Early detection
  • HE4
  • Ovarian cancer
  • Serum biomarkers

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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