Validation of serum biomarkers for detection of early-stage ovarian cancer

Am J Obstet Gynecol. 2009 Jun;200(6):639.e1-5. doi: 10.1016/j.ajog.2008.12.042. Epub 2009 Mar 14.


Objective: Ovarian cancer has the highest mortality of all the gynecologic malignancies with most patients diagnosed at late stages. Serum CA-125 is elevated in only half of patients with stages I-II. We identified 3 serum proteins (apolipoprotein A-1, transthyretin, and transferrin) for the detection of ovarian cancer and reported them combined with CA-125 to effectively detect early-stage mucinous tumors. The objectives of this study were to assess the effectiveness of the panel in detection of early-stage serous and endometrioid ovarian cancers.

Study design: In all, 358 serum samples (control, benign adnexal masses, and early-stage and late-stage ovarian cancer) were obtained from the National Cancer Institute. The level of each marker was measured. Multiple logistic regression models were built to calculate sensitivity and specificity.

Results: When combined with CA-125, the panel detected early-stage cancer with a sensitivity of 96%. The highest sensitivity was seen for detection of endometrioid subtype of early-stage carcinomas (98%).

Conclusion: A panel of 4 serum biomarkers effectively detected early-stage ovarian cancers with the highest reported overall sensitivity of 96%. Endometrioid tumors were detected at early stages with a sensitivity of 98%. Prospective clinical analysis of the panel is needed to validate it as an effective screening tool for early-stage ovarian cancer.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Validation Study

MeSH terms

  • Adult
  • Apolipoprotein A-I / blood*
  • Biomarkers / blood
  • CA-125 Antigen / blood*
  • Early Detection of Cancer*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Ovarian Neoplasms / blood*
  • Ovarian Neoplasms / diagnosis*
  • Prealbumin / analysis*
  • Sensitivity and Specificity
  • Transferrin / analysis*


  • Apolipoprotein A-I
  • Biomarkers
  • CA-125 Antigen
  • Prealbumin
  • Transferrin