The clinical utility of serum anti-Müllerian hormone in the follow-up of ovarian adult-type granulosa cell tumors--A comparative study with inhibin B

Int J Cancer. 2015 Oct 1;137(7):1661-71. doi: 10.1002/ijc.29532. Epub 2015 Apr 11.


Ovarian adult-type granulosa cell tumors (AGCTs) require prolonged follow-up, but evidence regarding the optimal follow-up marker is lacking. The objective of our study was to validate the clinical usefulness of serum anti-Müllerian hormone (AMH) and the current marker inhibin B as single and combined markers of AGCTs. We conducted a longitudinal, partially prospective cohort study of 123 premenopausal and postmenopausal AGCT patients with a median follow-up time of 10.5 years (range 0.3-50.0 years). Serum AMH and inhibin B levels were measured from 560 pretreatment and follow-up serum samples by using immunoenzymometric assays. We found that serum AMH and inhibin B levels were significantly elevated in patients with primary or recurrent AGCTs. The levels of both markers positively correlated to tumor size (p < 0.05). AMH and inhibin B performed similarly in receiving operator characteristic analyses; area under the curve (AUC) values were 0.92 [95% confidence interval (CI) 0.88-0.95] for AMH, and 0.94 (95% CI 0.90-0.96) for inhibin B. AMH was highly sensitive (92%) and specific (81%) in detecting a macroscopic AGCT. However, in AUC comparison analyses, the combination of the markers was superior to inhibin B alone. In conclusion, serum AMH is a sensitive and specific marker of AGCT, and either AMH or inhibin B can be monitored during follow-up. However, combining AMH and inhibin B in AGCT patient follow-up improves the detection of recurrent disease.

Keywords: anti-Müllerian hormone; granulosa cell tumor; inhibin B; ovarian cancer; serum marker.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Mullerian Hormone / blood*
  • Biomarkers, Tumor / blood*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Granulosa Cell Tumor / blood*
  • Humans
  • Inhibins / blood*
  • Longitudinal Studies
  • Middle Aged
  • Ovarian Neoplasms / blood*
  • Young Adult


  • Biomarkers, Tumor
  • inhibin B
  • Inhibins
  • Anti-Mullerian Hormone