Utility of mesothelin, L1CAM and Afamin as biomarkers in primary ovarian cancer

Anticancer Res. 2013 Jan;33(1):329-36.


Background: We evaluated the prognostic value of the new serum biomarkers mesothelin (cell surface glycoprotein and tumor differentiation antigen), L1 cell adhesion molecule (L1CAM) and afamin (vitamin D-binding protein) alone and in combination with cancer antigen 125 (CA125) in serum samples of 154 patients with first-diagnosis of primary ovarian cancer, before surgery and after platinum-based chemotherapy. We correlated these findings with clinical parameters and evaluated their prognostic value with regard to overall survival (OS).

Materials and methods: Blood (9 ml) was obtained before surgery (n=154) and after chemotherapy (n=82) for the measurement of serum markers using commercial Enzyme Linked Immunosorbent Assay (ELISA) kits for mesothelin, L1CAM, afamin and CA125. Mesothelin positivity was defined as >2.0 nM, L1CAM as >10 ng/ml, afamin as <45 mg/l and CA125 as >35 U/ml, respectively.

Results: Before surgery, mesothelin positivity significantly correlated with advanced International Federation of Gynecology and Obstetrics (FIGO) stage (p=0.002), residual postoperative tumor (p<0.0001), serous histological subtype (p<0.0001) and higher age (p=0.013). Elevated CA125 levels significantly correlated with advanced FIGO stage (p<0.0001) and grading (p=0.012). After chemotherapy, mesothelin as well as CA125 levels, were significantly associated with FIGO stage (p=0.041 and p=0.017) and residual tumor (p=0.022 and p=0.002) while L1CAM correlated with platinum sensitivity (p=0.041). In contrast, afamin at all determined time points showed no correlation with any of these parameters. The combination of markers did not add any significant power to their use.

Conclusion: Mesothelin and L1CAM appear to correlate with clinical prognostic parameters and might be useful biomarkers for therapy monitoring and, thus, could serve as attractive targets for therapy of ovarian cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Pharmacological / blood
  • Biomarkers, Tumor / blood
  • CA-125 Antigen / blood
  • Carrier Proteins / blood*
  • Female
  • GPI-Linked Proteins / blood*
  • Glycoproteins / blood*
  • Humans
  • Mesothelin
  • Middle Aged
  • Neoplasm Staging
  • Neural Cell Adhesion Molecule L1 / blood*
  • Ovarian Neoplasms / blood*
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / pathology
  • Prognosis
  • Serum Albumin
  • Serum Albumin, Human


  • AFM protein, human
  • Biomarkers, Pharmacological
  • Biomarkers, Tumor
  • CA-125 Antigen
  • Carrier Proteins
  • GPI-Linked Proteins
  • Glycoproteins
  • Neural Cell Adhesion Molecule L1
  • Serum Albumin
  • Mesothelin
  • Serum Albumin, Human