Ovarian cancer laboratory findings

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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.

Laboratory finding

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• 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
  • CBC
  • CBP
• Serum biomarkers of epithelial ovarian cancer (EOC):
  • CA 125
    • 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 US shows highly suspicious malignant mass
  • HE4
    • 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
• 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