COMPARISON BETWEEN HAPTOGLOBIN AND CA125 TO PREDICT NATURE OF OVARIAN MASS

Abstract

Background:Ovarian cancer has been named "the silent killer" because it frequently causes non-specific symptoms, which contribute to diagnostic delay, diagnosis in a late stage and poor prognosis. Despite of the improved surgical techniques and effective chemotherapeutic regimens available for management of ovarian cancer, there is no improvement in its early detection. Thus ovarian cancer remains a leading cause of death from gynecological malignancies with an overall poor prognosis. The identification of novel cancer biomarker opens the possibility for early detection, better monitoring of tumor progression. Haptoglobin is a novel biomarker which was used in diagnosis in ovarian cancer. Objectives: To assess the performance of haptoglobin and CA125 to increase the sensitivity and specificity in diagnosis of nature of ovarian mass and to assess the diagnostic value of haptoglobin in cases of ovarian neoplasia. Methods: This study was carried out on 90 women attending El-Hussein and Bab El-Sheria University Hospital, a prospective study was held on patients with ovarian mass prepared for surgery. It is a case control study. It incorporated on 60 patients with ovarian masses and 30 women without masses. Those patients were subjected to careful history taking, clinical examination, ultrasound examination and preoperative assessment of serum levels of Haptoglobin and CA125. Results: Analysis of CA-125 as a single biomarker using calculated cut off value >36 U/ml shows that the sensitivity was 90.0%, specificity 92.0% in the diagnosis of malignant ovarian tumors with p value = (0.002). Analysis of Serum haptoglobin as a single biomarker using calculated cut off value >1.9 mg /ml shows that the sensitivity was 88.0%, specificity 85.0% in the diagnosis of malignant ovarian tumors with p value = (0.0016). Analysis of both Serum CA-125 and haptoglobin biomarkers using calculated cut off value >36 U/ml and >1.9 mg/ml respectively shows that the sensitivity of both was 94.0%, specificity 93.0% in the diagnosis of malignant ovarian tumors with p value = (0.001). Conclusion: Haptoglobin has an important role in the evaluation of ovarian cancer and its serum level increases in early stages of cancer ovary. It increases significantly in malignant ovarian tumors than in benign ovarian tumors, so it can be used as a diagnostic tumor marker in cases of ovarian neoplasia so haptoglobin is a novel tumor marker for ovarian cancer with accuracy near to that of CA125.