Objective: To compare the diagnostic value of the simultaneous evaluation of osteopontin (OPN), insulin-growth factor II (IGF II), leptin, prolactin with the use of transvaginal ultrasonography and CA 125 determination for detection of ovarian cancer. Material and methods: Eighty-three patients with an adnexal mass were included in this study and underwent sonography and ELISA assays of the four serum protein markers before surgery, associated also with the determination of CA125. For the evaluation of diagnostic performance of bio-markers we also used split-point analysis to produce a score-based classification method in which a score of 1 or below is required for benign mass, whereas a score of 2 or above indicates cancer. Results: Ten patients with ovarian cancer and 73 patients with benign ovarian neoplasm were included in the study. The median concentrations of OPN, IGF II, leptin and prolactin were not significantly different in the two groups of patients. With receiver operating characteristic curve analysis, the area under the curve was respectively 0.384 for OPN, 0.395 for IGF II, 0.570 for leptin, 0.453 for prolactin and 0.838 for CA125. Using split-point scoring methods, the simultaneous evaluation of the four new serum markers had sensitivity of 80% and specificity of 10%. With the use of only CA125 a sensitivity of 68% and specificity of 40% were obtained. The ultrasonography showed a sensitivity of 80% but a specificity of 92%. Conclusions: Although previously proposed with encouraging results in the screening of ovarian cancer, the simultaneous evaluation of these new biomarkers not seems to be useful in the preoperative evaluation of patients with an adnexal mass when compared with CA125 and transvaginal ultrasonography. This study was supported by Assessorato Igiene e Sanita, Regione Autonoma della Sardegna.
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Sep 14, 2011
E Ancuta + 3
Open Access
