REG4 Is Highly Expressed in Mucinous Ovarian Cancer: A Potential Novel Serum Biomarker

PLoS One. 2016 Mar 16;11(3):e0151590. doi: 10.1371/journal.pone.0151590. eCollection 2016.

Abstract

Preoperative diagnostics of ovarian neoplasms rely on ultrasound imaging and the serum biomarkers CA125 and HE4. However, these markers may be elevated in non-neoplastic conditions and may fail to identify most non-serous epithelial cancer subtypes. The objective of this study was to identify histotype-specific serum biomarkers for mucinous ovarian cancer. The candidate genes with mucinous histotype specific expression profile were identified from publicly available gene-expression databases and further in silico data mining was performed utilizing the MediSapiens database. Candidate biomarker validation was done using qRT-PCR, western blotting and immunohistochemical staining of tumor tissue microarrays. The expression level of the candidate gene in serum was compared to the serum CA125 and HE4 levels in a patient cohort of prospectively collected advanced ovarian cancer. Database searches identified REG4 as a potential biomarker with specificity for the mucinous ovarian cancer subtype. The specific expression within epithelial ovarian tumors was further confirmed by mRNA analysis. Immunohistochemical staining of ovarian tumor tissue arrays showed distinctive cytoplasmic expression pattern only in mucinous carcinomas and suggested differential expression between benign and malignant mucinous neoplasms. Finally, an ELISA based serum biomarker assay demonstrated increased expression only in patients with mucinous ovarian cancer. This study identifies REG4 as a potential serum biomarker for histotype-specific detection of mucinous ovarian cancer and suggests serum REG4 measurement as a non-invasive diagnostic tool for postoperative follow-up of patients with mucinous ovarian cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Mucinous / blood
  • Adenocarcinoma, Mucinous / metabolism*
  • Adenocarcinoma, Mucinous / pathology
  • Biomarkers, Tumor / metabolism
  • CA-125 Antigen / blood
  • Databases, Factual
  • Female
  • Humans
  • Lectins, C-Type / blood
  • Lectins, C-Type / metabolism*
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / metabolism*
  • Ovarian Neoplasms / pathology
  • Pancreatitis-Associated Proteins
  • Proteins / metabolism
  • WAP Four-Disulfide Core Domain Protein 2

Substances

  • Biomarkers, Tumor
  • CA-125 Antigen
  • Lectins, C-Type
  • Pancreatitis-Associated Proteins
  • Proteins
  • REG4 protein, human
  • WAP Four-Disulfide Core Domain Protein 2
  • WFDC2 protein, human

Grants and funding

This study was supported by Sigrid Juselius Foundation, http://www.sigridjuselius.fi/foundation, to LL, TK, KK; Finnish Cancer Society, https://www.cancersociety.fi/grants/, to LL, PR, TK, KK; Turku University Hospital Research Fund, http://www.vsshp.fi/en/toimipaikat/tyks/Pages/default.aspx, to LL, PR, KK; European Regional Development Fund (A31859), http://ec.europa.eu/regional_policy/EN/funding/erdf/, to LL, PR, KK, PV, LH, KI, HS, OC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.