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Autoantibodies, antigen-autoantibody complexes and antigens complement CA125 for early detection of ovarian cancer

Menée à partir d'échantillons sériques prélevés sur 502 témoins et 450 patientes présentant une masse pelvienne bénigne ou atteintes d'un cancer de l'ovaire de stade I à IV, cette étude identifie un panel de 4 biomarqueurs (CA125, HE4, HE4 Ad-AAB et ostéopontine) pour détecter précocement un cancer de l'ovaire

Background : Multiple antigens, autoantibodies (AAb), and antigen-autoantibody (Ag-AAb) complexes were compared for their ability to complement CA125 for early detection of ovarian cancer.

Methods : Twenty six biomarkers were measured in a single panel of sera from women with early stage (I-II) ovarian cancers (n = 64), late stage (III-IV) ovarian cancers (186), benign pelvic masses (200) and from healthy controls (502), and then split randomly (50:50) into a training set to identify the most promising classifier and a validation set to compare its performance to CA125 alone.

Results : Eight biomarkers detected 

 8% of early stage cases at 98% specificity. A four-biomarker panel including CA125, HE4, HE4 Ag-AAb and osteopontin detected 75% of early stage cancers in the validation set from among healthy controls compared to 62% with CA125 alone (p = 0.003) at 98% specificity. The same panel increased sensitivity for distinguishing early-stage ovarian cancers from benign pelvic masses by 25% (p = 0.0004) at 95% specificity. From 21 autoantibody candidates, 3 AAb (anti-p53, anti-CTAG1 and annt-Il-8) detected 22% of early stage ovarian cancers, potentially lengthening lead time prior to diagnosis.

Conclusion : A four biomarker panel achieved greater sensitivity at the same specificity for early detection of ovarian cancer than CA125 alone.

British Journal of Cancer , article en libre accès, 2024

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