Ovarian cancer diagnosis

Luo LY, Katsaros D, Scorilas A, et al. The serum concentration of human kallikrein 10 represents a novel biomarker for ovarian cancer diagnosis and prognosis. Cancer Res 2003 63 807-811. 

As with many other disease states, a significant risk factor associated with ovarian cancer is aging. A womans risk increases from 15.7% to 54% per 100,000 as her age advances from 40 to 79 years, with the mean age at diagnosis being 59 years.2... 

Pelvic examinations are effective in detecting obvious tumors with a sensitivity of 67% for detecting all tumors minimal or microscopic disease cannot be detected on physical examination.9 Pelvic examinations are non-invasive and well accepted, but they do not usually detect ovarian cancer until it is in an advanced stage. Therefore, routine pelvic examinations will not improve earlier diagnosis or help to decrease overall mortality.9... 

Serum and tissue from ovarian cancer patients ELISA Diagnosis Elevated serum levels in 65% of ovarian cancer patients vs. normal Higher levels in 40% of ovarian cancer tissues compared to normal [258]... 

Ovarian cancer patients with progressed disease often present with ascites/ peritoneal fluid. In some women, ovarian cysts are detected containing cystic fluid. The concentrations of suPAR in these body fluids were compared with those in serum made from peripheral blood and blood aspirated from the surface veins on the tumor in 77 patients admitted for surgery of ovarian tumors [21]. In this study, elevated levels of suPAR were measured in serum from peripheral blood and tumor blood in the patients with more advanced disease. However, the concentrations of suPAR in the body fluids were quite different, in serum the measured concentrations were between 46 and 98 pmol/liter, in ascites/peritoneal fluid concentrations were between 293 and 586 pmol/liter, and in cystic fluids the concentrations were even higher, that is 651-8468 pmol/liter. The concentrations of suPAR in cystic fluids clearly separated benign and malignant cysts with predictive values above 90%. The levels of suPAR in cystic fluids could therefore be used in the early diagnosis of ovarian cancer patients. The suPAR in the cystic fluids was present both in intact and cleaved forms and at least some of the suPAR(I-III) was not occupied by uPA [21]. In another study, tumor tissue, serum, ascites, and urine from ovarian cancer patients were analyzed for their content of the different uPAR forms. Whereas all of tumor lysates, ascites, and urine contained uPAR(I-III) and uPAR(II-III), domain I was only present in urine samples. In serum, only intact suPAR was detected [82], The antibodies used for identification were mAb R3 (domain I) and mAb R2 (domain III). 

Alkylating agents have been implicated in the causation of secondary tumors, including acute myeloid leukemia, myelodysplastic syndromes (69), solid tumors (70,71), Hodgkin s disease (72,73), ovarian cancer (74,75), and gastric cancer (69). Survival from the time of diagnosis of secondary malignancies is usually very short (69). 

Hair may also be an important tool for the diagnosis and monitoring of various disease states. For example, the concentrations of polyamines (e.g., putrescine, spermidine, and spermine) in the hair may be helpful in diagnosing and assessing disease activity in women with cervical or ovarian cancer. Assessing the level of polyamines in the hair shaft is preferred to measuring them in plasma and urine because the polyamine levels can vary during the day in plasma and urine. Increased levels of porphyrins in hair have been detected in patients with porphyria... 

Survival of patients with advanced ovarian cancer is a func- tion of stage at initial diagnosis and the amount of residual disease after surgical debulking. Patients with stage III dis-... 

Unfortunately, most patients have disseminated disease at diagnosis because symptoms are nonspecific and may not be recognized until late in the disease course." Overall 5-year survival is slightly higher for white Americans (44%) as compared with African-Americans (38%). Survival for patients with localized disease is similar for white Americans and African-Americans (93%). Surgery is an integral part of ovarian cancer management. Chemotherapy,... 

Approximately one-third of ovarian cancer patients present with localized disease (stage I or E) at initial diagnosis. In patients with... 

Because of the insidious onset and progression of ovarian cancer, an early diagnosis is very difficult. Moreover, accurate monitoring of tumor status is also difficult because patients are often in clinical remission when subclinical disease is present. 

In patients with epithelial ovarian carcinomas, serum Mn-SOD levels increased in accordance with the clinical progression of disease. At the early stage, however, the incidence of cases with elevated serum levels was low. Therefore measurements of serum Mn-SOD may not always be useful for the early diagnosis of epithelial ovarian carcinoma. The decline in serum Mn-SOD levels following affective therapy seems to reflect the disappearance of lesions. Decreases occurred after therapy and increases occurred with recurrences. Thus it appears that the measurement of this enzyme in serum can provide useful data for monitoring epithelial ovarian cancer following therapy, and for the early diagnosis of recurrences of the disease. 

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