This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Baron, A. T. Articles by Maihle, N. J. Search for Related Content PubMed PubMed Citation Articles by Baron, A. T. Articles by Maihle, N. J.

Soluble Epidermal Growth Factor Receptor (SEG-FR) and Cancer Antigen 125 (CA125) as Screening and Diagnostic Tests for Epithelial Ovarian Cancer

¹ Department of Internal Medicine, Division of Hematology/Oncology, University of Kentucky, Lucille P. Markey Cancer Center, Lexington, Kentucky; ² Department of Obstetrics and Gynecology, Medical College of Virginia, Virginia Commonwealth University Health System, Richmond, Virginia; ³ Tumor Biology Program and ⁴ Department of Gynecologic Surgery/Oncology, Mayo Clinic-Rochester, Rochester, Minnesota; ⁵ Departments of Preventive Medicine and ⁶ Obstetrics and Gynecology, Northwestern University's Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois; and ⁷ Department of Obstetrics/Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut

Requests for reprints: Andre T. Baron, Department of Internal Medicine, Division of Hematology/Oncology, Lucille P. Markey Cancer Center, University of Kentucky, 408 Roach Building, 800 Rose Street, Lexington, KY 40536-0093. Phone: 859-323-1729; Fax: 859-257-7715. E-mail: a.baron{at}uky.edu

Epithelial ovarian cancer (EOC) is the leading cause of death among all gynecologic cancers in the United States. Because women who are diagnosed with early stage disease have a better prognosis than women diagnosed with late stage disease, early detection represents a potentially practical approach to reduce the mortality associated with EOC. Unfortunately, no single screening test has proven to be effective for this purpose, and a valid and feasible screening program to detect early stage EOC in the general population has not yet been devised. Consequently, research has focused on coupling two or more screening modalities to improve program validity and feasibility. Serum cancer antigen 125 (CA125) and a soluble isoform of the epidermal growth factor receptor (p110 sEGFR) have been studied individually as biomarkers of ovarian cancer. In this study, we compare serum CA125 levels and sEGFR concentrations in women with EOC to women with benign gynecologic conditions of ovarian and non-ovarian origin. We show that serum sEGFR concentrations are lower in patients with EOC than in women with benign gynecologic conditions, whereas serum CA125 levels are higher in patients to EOC compared with women with benign gynecologic conditions. These data also reveal that age and serum sEGFR concentrations modify the association between CA125 levels and EOC versus benign gynecologic disease. Hence, age- and sEGFR-dependent CA125 cutoff thresholds improve the ability of CA125 to discern EOC patients from women with benign ovarian tumors and non-ovarian gynecologic conditions. Our analyses show that parallel testing with fixed sEGFR and CA125 cutoff thresholds optimizes sensitivity to detect EOC, whereas serial testing with age- and sEGFR-dependent CA125 cutoff thresholds optimizes test specificity, and overall accuracy to discern patients with EOC from women with benign ovarian and non-ovarian gynecologic conditions. The combined use of serologic sEGFR and CA125, thus, has improved utility for screening and diagnosing EOC, which may increase the positive predictive value of a multimodal screening program that incorporates these biomarkers to detect and subsequently differentiate benign from malignant ovarian tumors.

This article has been cited by other articles:

				G. P. Bertenshaw, P. Yip, P. Seshaiah, J. Zhao, T.-H. Chen, W. S. Wiggins, J. P. Mapes, and B. C. Mansfield Multianalyte Profiling of Serum Antigens and Autoimmune and Infectious Disease Molecules to Identify Biomarkers Dysregulated in Epithelial Ovarian Cancer Cancer Epidemiol. Biomarkers Prev., October 1, 2008; 17(10): 2872 - 2881. [Abstract] [Full Text] [PDF]

				S. Fredriksson, J. Horecka, O. Terje Brustugun, J. Schlingemann, A. C. Koong, R. Tibshirani, and R. W. Davis Multiplexed Proximity Ligation Assays to Profile Putative Plasma Biomarkers Relevant to Pancreatic and Ovarian Cancer Clin. Chem., March 1, 2008; 54(3): 582 - 589. [Abstract] [Full Text] [PDF]

				N. Scholler, M. Crawford, A. Sato, C. W. Drescher, K. C. O'Briant, N. Kiviat, G. L. Anderson, and N. Urban Bead-based ELISA for validation of ovarian cancer early detection markers. Clin. Cancer Res., April 1, 2006; 12(7 Pt 1): 2117 - 2124. [Abstract] [Full Text] [PDF]

				Soluble Epidermal Growth Factor Receptor (sEGFR) and Cancer Antigen 125 (CA 125) as Screening and Diagnostic Tests for Epithelial Ovarian Cancer Cancer Epidemiol. Biomarkers Prev., June 1, 2005; 14(6): 1583 - 1583. [Full Text] [PDF]