HE4 כמרקר מוצלח לסרטן שחלות בעיקר בשלביו הראשוניים

New Biomarker Could Improve Detection of Ovarian Cancer Zosia Chustecka Medscape Medical News 2007. © 2007 Medscape December 21, 2007 ­ A new biomarker, serum levels of HE4, could improve the detection of ovarian cancer, particularly in the early stages, when there is a better chance of successful treatment, say researchers reporting a prospective study online December 3 in Gynecologic Oncology. A test for this biomarker (developed by Fujirebio Diagnostics) is awaiting approval by the FDA. HE4 was the most effective of the 9 biomarkers that the researchers evaluated, AND was better than CA125, which is currently the most widely used serum biomarker for detecting ovarian cancer and is considered to be the gold standard. Using HE4 in combination with CA125 improved the results further. "Our results show that testing women suspected of ovarian cancer for both CA125 AND HE4 could possibly lead to a screening AND diagnostic tool," said lead researcher Richard G. Moore, MD, from Women AND Infants Hospital, Brown University, in Providence, Rhode Island. In an interview with Medscape Oncology, he explained that testing for these biomarkers would be particularly useful in a triage situation where women present with a pelvic mass because it could predict who is likely to have ovarian cancer. These patients could then be steered toward specialists centers; data show that specialist surgery AND treatment of ovarian cancer leads to less morbidity AND a higher survival rate. In the future, there is also hope that these biomarkers could be used for screening populations of healthy postmenopausal women to detect ovarian cancer in the early stages, when it is most treatable, he said. Such studies are currently being planned in the United States, but 1 screening study with CA125 is already underway in the United Kingdom, he said. The study conducted by Dr. Moore AND colleagues involved 256 women who presented with an adnexal mass AND were scheduled to undergo surgery. Serum and urine samples taken preoperatively were then compared with results from biopsies. Of the 233 patients who were eligible for analysis, 67 were found to have invasive epithelial ovarian cancers and 166 had benign ovarian neoplasms. Among the 67 patients found to have ovarian cancer, 13 (19%) were diagnosed with surgical stage 1 disease, 2 (3%) with stage 2 disease, 46 (69%) with stage 3 disease, AND 6 (95%) with stage 4 disease. Dr. Moore AND colleagues investigated 9 different biomarkers. In addition to HE4 AND CA125, they also tested blood for soluble mesothelin-related peptide (SMRP), CA72-4, activin A, inhibin, osteopontin, epidermal growth factor, AND serum Her2. Urinary levels of SMRP AND CA125 were also analyzed. The levels for all these biomarkers (with the exception of Her2) were significantly different between patients with cancer AND those with benign masses, indicating their ability to identify malignant disease. Serum HE4 had the highest sensitivity (72.9%) for detecting a malignancy, at the specificity of 95%. When HE4 was combined with CA125, this increased further to yield a sensitivity of 76.4% AND a specificity of 95%. The combination of both biomarkers added 3.5% to the sensitivity of HE4 alone, AND 33.1% to the sensitivity of CA125 alone, the researchers comment. Adding 1 OR more biomarkers added only a small percentage to the sensitivity of combined HE4 AND CA125, AND did not increase it significantly. "Such additions are of limited incremental value" to the combination of HE4 AND CA125, say the researchers. HE4 also had the highest sensitivity (45.9%, with a specificity of 95%) for detecting stage 1 disease AND differentiating it from benign masses. CA125 alone is of no clinical value in this group of patients, the researchers note. In addition, HE4 had a greater sensitivity for a given specificity than CA125 for women who were premenopausal, although the sensitivity of both biomarkers was similar in postmenopausal women. "This study demonstrates that the addition of HE4 to CA125 significantly elevates the sensitivity and specificity over that of CA125 alone," the researchers conclude. The study was supported by grants from Ovarian Cancer SPORE AND the National Cancer Institute. Dr. Moore has disclosed no relevant financial relationships. Gynecologic Oncology. Published online December 3, 2007. בברכה, גובי http://www.cure-cancer-naturally.com/

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