Abstract

Ovarian cancer is one of the most common gynecological malignancies, ranking third after cervical and uterine cancer. High-grade serous ovarian cancer (HGSOC) is one of the most aggressive subtype, and the late onset of its symptoms leads in most cases to an unfavourable prognosis. Current predictive algorithms used to estimate the risk of having Ovarian Cancer fail to provide sufficient sensitivity and specificity to be used widely in clinical practice. The use of additional biomarkers or parameters such as age or menopausal status to overcome these issues showed only weak improvements. It is necessary to identify novel molecular signatures and the development of new predictive algorithms able to support the diagnosis of HGSOC, and at the same time, deepen the understanding of this elusive disease, with the final goal of improving patient survival. Here, we apply a Machine Learning-based pipeline to an open-source HGSOC Proteomic dataset to develop a decision support system (DSS) that displayed high discerning ability on a dataset of HGSOC biopsies. The proposed DSS consists of a double-step feature selection and a decision tree, with the resulting output consisting of a combination of three highly discriminating proteins: TOP1, PDIA4, and OGN, that could be of interest for further clinical and experimental validation. Furthermore, we took advantage of the ranked list of proteins generated during the feature selection steps to perform a pathway analysis to provide a snapshot of the main deregulated pathways of HGSOC. The datasets used for this study are available in the Clinical Proteomic Tumor Analysis Consortium (CPTAC) data portal (https://cptac-data-portal.georgetown.edu/).

Highlights

  • Ovarian cancer is one of the most common gynecological malignancies, ranking third after cervical and uterine cancer

  • We provided a reliable overview of the most relevant deregulated pathways in High-grade serous ovarian cancer (HGSOC), focusing mainly on those genes that were not related directly to HGSOC before, providing novel associations and new starting points for future researches

  • We developed a Decision Support System able to find three possible Biomarkers for the diagnosis of HGSOC

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Summary

Introduction

Ovarian cancer is one of the most common gynecological malignancies, ranking third after cervical and uterine cancer. EXPLAINABLE DSS prognosis of patients with a pelvic mass suspected of HGSOC Those treated by gynecologic oncologists had significantly lower morbidity and overall increased survival than those treated by general gynecologists and general ­surgeons[5, 8,9,10]. Several biomarkers, such as C­ A12511, ­HE412 and ­osteopontin[13] have been used for the risk assessment of ovarian cancer in patients with a pelvic mass. Each of the biomarkers can be used alone or combined in multiplebiomarker algorithms (e.g. R­ MI14, ­ROMA15, ­OVA116), having received both FDA and EU approval 17

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