Ovarian cancer remains the most lethal of gynecological malignancies, with the 5-year survival below 50%. Currently there is no simple and effective pre-surgical diagnosis or triage for patients with malignancy, particularly those with early-stage or low-volume tumors. Recently we discovered that CXCL10 can be processed to an inactive form in ovarian cancers and that its measurement has diagnostic significance. In this study we evaluated the addition of processed CXCL10 to a biomarker panel for the discrimination of benign from malignant disease. Multiple biomarkers were measured in retrospectively collected plasma samples (n= 334) from patients diagnosed with benign or malignant disease, and a classifier model was developed using CA125, HE4, Il6 and CXCL10 (active and total). The model provided 95% sensitivity/95% specificity for discrimination of benign from malignant disease. Positive predictive performance exceeded that of “gold standard” scoring systems including CA125, RMI and ROMA% and was independent of menopausal status. In addition, 80% of stage I-II cancers in the cohort were correctly identified using the multi-marker scoring system. Our data suggest the multi-marker panel and associated scoring algorithm provides a useful measurement to assist in pre-surgical diagnosis and triage of patients with suspected ovarian cancer.
卵巢癌仍是妇科恶性肿瘤中致死率最高的疾病，其五年生存率低于50%。目前对于恶性肿瘤患者，特别是早期或小体积肿瘤患者，尚缺乏简便有效的术前诊断或分诊方法。近期研究发现，CXCL10在卵巢癌中可被加工为失活形式，其检测具有诊断意义。本研究评估了在生物标志物组合中加入加工型CXCL10对良恶性疾病的鉴别价值。通过回顾性收集确诊为良恶性疾病患者的血浆样本（n=334），检测了多种生物标志物，并利用CA125、HE4、Il6及CXCL10（活性与总量）构建了分类模型。该模型鉴别良恶性疾病的敏感性和特异性均达到95%，其阳性预测效能超越包括CA125、RMI和ROMA%在内的"金标准"评分系统，且不受绝经状态影响。此外，采用该多标志物评分系统可正确识别队列中80%的I-II期癌症病例。研究数据表明，该多标志物组合及配套评分算法可为疑似卵巢癌患者的术前诊断和分诊提供有效的检测手段。
A Novel Predictive Multi-Marker Test for the Pre-Surgical Identification of Ovarian Cancer
肿瘤(癌症)患者之家