Ovarian cancer laboratory findings: Difference between revisions
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==Laboratory finding== | ==Laboratory finding== | ||
* Patients with ovarian cancer can present acutely or sub-acutely | * Patients with [[ovarian cancer]] can present [[Acute|acutely]] or [[Subacute|sub-acutely]] | ||
* If there is clinical suspicion of malignancy, the evaluation includes laboratory work, imaging and surgical exploration for the definite diagnosis | * If there is clinical suspicion of [[malignancy]], the evaluation includes [[Laboratory|laboratory work]], [[imaging]] and [[surgical]] exploration for the definite [[diagnosis]] | ||
*Routine lab work | *Routine lab work | ||
**CBC | **[[CBC|complete blood count (CBC]]) | ||
**CMP | **Complete metabolic panel (CMP) | ||
*Serum biomarkers of epithelial ovarian cancer (EOC):<ref name="pmid11369781">{{cite journal| author=Yin BW, Lloyd KO| title=Molecular cloning of the CA125 ovarian cancer antigen: identification as a new mucin, MUC16. | journal=J Biol Chem | year= 2001 | volume= 276 | issue= 29 | pages= 27371-5 | pmid=11369781 | doi=10.1074/jbc.M103554200 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11369781 }} </ref> | *Serum [[biomarkers]] of [[epithelial ovarian cancer]] (EOC):<ref name="pmid11369781">{{cite journal| author=Yin BW, Lloyd KO| title=Molecular cloning of the CA125 ovarian cancer antigen: identification as a new mucin, MUC16. | journal=J Biol Chem | year= 2001 | volume= 276 | issue= 29 | pages= 27371-5 | pmid=11369781 | doi=10.1074/jbc.M103554200 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11369781 }} </ref> | ||
** | **[[CA125]] | ||
*** Considered the best for ovarian cancer detection, therapeutic monitoring, and detection of the tumor recurrence | *** Considered the best for [[ovarian cancer]] detection, [[therapeutic]] monitoring, and detection of the tumor recurrence | ||
***Postmenopausal woman: should be measured | ***[[Postmenopausal]] woman: should be measured | ||
*** Premenopausal woman: should be measured only if | ***[[Premenopausal]] woman: should be measured only if [[ultrasonogram]] shows highly suspicious malignant mass | ||
** HE4 <ref name="pmid15781627">{{cite journal| author=Drapkin R, von Horsten HH, Lin Y, Mok SC, Crum CP, Welch WR et al.| title=Human epididymis protein 4 (HE4) is a secreted glycoprotein that is overexpressed by serous and endometrioid ovarian carcinomas. | journal=Cancer Res | year= 2005 | volume= 65 | issue= 6 | pages= 2162-9 | pmid=15781627 | doi=10.1158/0008-5472.CAN-04-3924 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15781627 }} </ref> | ** HE4 <ref name="pmid15781627">{{cite journal| author=Drapkin R, von Horsten HH, Lin Y, Mok SC, Crum CP, Welch WR et al.| title=Human epididymis protein 4 (HE4) is a secreted glycoprotein that is overexpressed by serous and endometrioid ovarian carcinomas. | journal=Cancer Res | year= 2005 | volume= 65 | issue= 6 | pages= 2162-9 | pmid=15781627 | doi=10.1158/0008-5472.CAN-04-3924 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15781627 }} </ref> | ||
***CA125 and HE4 are used together to increase the sensitivity and specificity of ovarian cancer detection | ***CA125 and HE4 are used together to increase the sensitivity and specificity of ovarian cancer detection | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.
Overview
The evaluation includes laboratory work, imaging and surgical exploration for the definite diagnosis.
Routine lab work includes CBC and CMP, Serum biomarkers of of epithelial ovarian cancer includes CA125, HE4, OVA1. Serum biomarkers of the germ cell and sex cord-stromal ovarian cancer include AFP, hCG, LDH, E2, Inhibin, testosterone, androstenedione, dehydroepiandrostenedione, anti-Müllerian hormone.
Laboratory finding
- Patients with ovarian cancer can present acutely or sub-acutely
- If there is clinical suspicion of malignancy, the evaluation includes laboratory work, imaging and surgical exploration for the definite diagnosis
- Routine lab work
- complete blood count (CBC)
- Complete metabolic panel (CMP)
- Serum biomarkers of epithelial ovarian cancer (EOC):[1]
- CA125
- Considered the best for ovarian cancer detection, therapeutic monitoring, and detection of the tumor recurrence
- Postmenopausal woman: should be measured
- Premenopausal woman: should be measured only if ultrasonogram shows highly suspicious malignant mass
- HE4 [2]
- CA125 and HE4 are used together to increase the sensitivity and specificity of ovarian cancer detection
- Risk of Ovarian Malignancy Algorithm (ROMA) is used to decide if the patient has a high risk or low-risk malignant disease based on:
- CA125 and HE4 levels
- Menopausal status of the woman
- OVA1[3][4][5]
- CA125
- Serum biomarkers of the germ cell and sex cord-stromal ovarian cancer:
- AFP: alpha-fetoprotein
- hCG: human chorionic gonadotropin
- LDH: lactate dehydrogenase
- E2: estradiol
- Inhibin
- Testost: testosterone
- Andro: androstenedione
- DHEA: dehydroepiandrostenedione
- AMH: anti-Müllerian hormone
- The gene for CA 125 was cloned in 2001 and is called MUC16[1]
- radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer[3]
- CA125 and the second generation test (CA125 II) are both cliniclaly equivalent[6]
References
- ↑ 1.0 1.1 Yin BW, Lloyd KO (2001). "Molecular cloning of the CA125 ovarian cancer antigen: identification as a new mucin, MUC16". J Biol Chem. 276 (29): 27371–5. doi:10.1074/jbc.M103554200. PMID 11369781.
- ↑ Drapkin R, von Horsten HH, Lin Y, Mok SC, Crum CP, Welch WR; et al. (2005). "Human epididymis protein 4 (HE4) is a secreted glycoprotein that is overexpressed by serous and endometrioid ovarian carcinomas". Cancer Res. 65 (6): 2162–9. doi:10.1158/0008-5472.CAN-04-3924. PMID 15781627.
- ↑ 3.0 3.1 Bast RC, Klug TL, St John E, Jenison E, Niloff JM, Lazarus H; et al. (1983). "A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer". N Engl J Med. 309 (15): 883–7. doi:10.1056/NEJM198310133091503. PMID 6310399.
- ↑ Jacobs I, Bast RC (1989). "The CA 125 tumour-associated antigen: a review of the literature". Hum Reprod. 4 (1): 1–12. doi:10.1093/oxfordjournals.humrep.a136832. PMID 2651469.
- ↑ Zhang Z, Bast RC, Yu Y, Li J, Sokoll LJ, Rai AJ; et al. (2004). "Three biomarkers identified from serum proteomic analysis for the detection of early stage ovarian cancer". Cancer Res. 64 (16): 5882–90. doi:10.1158/0008-5472.CAN-04-0746. PMID 15313933.
- ↑ Mongia SK, Rawlins ML, Owen WE, Roberts WL (2006). "Performance characteristics of seven automated CA 125 assays". Am J Clin Pathol. 125 (6): 921–7. doi:10.1309/NBA3-12W0-LANR-XYH9. PMID 16690492 PMID 16690492 Check
|pmid=value (help).