Biomarkers increase survival in ovarian cancer
1Sahlgrenska Cancer Center, Clinical Sciences, Ob&Gyn, Göteborg, Sweden
Ovarian cancer is the fifth most common cause of cancer related deaths in females in the Western world. During 2011, 676 women was diagnosed with EOC in Sweden and 563 women died from the disease. Most ovarian cancers are diagnosed at an advanced stage, with tumor spread beyond surgical control. It is a highly metastatic disease and the survival rate is low, < 30 %, for patients with high stage disease. Survival rate for patients with ovarian cancer still limited to the ovary is 90%. Early diagnostics is a real challenge that will save lives.
Epithelial derived ovarian tumours commonly grow with cystic formations and the cells are producing fluids. The ovarian cyst fluid most likely includes secreted proteins from the local microenvironment, the ovarian tumours. Pathological changes within the ovaries could be reflected in the proteomic patterns found in the cyst fluids, and these changes may differ between benign and malignant ovarian tumours of different grades and stages and histology.
Because of the lack of exact biomarkers for ovarian cancer it is difficult to correctly diagnose patients already in early stage, resulting in unnecessary operations of benign cysts and increased morbidity for the patient. In fact 7-10 benign ovarian cysts has to be removed to find one ovarian cancer. Several risk malignancy algorithms has been developed to increase sensitivity. The well-known serum biomarker Cancer Antigen-125 (CA-125) can now be combined with serum Human epididymis-4 (HE-4) for early stage ovarian cancer diagnostics also in fertile women.
Epithelial ovarian cancer is a highly heterogenic disease and even though a flood of new biomarkers have been presented none can diagnose all histologic subtypes leading to hesitations in the diagnostic situation. It will be a great challenge to find biomarkers for all ovarian cancer subtypes and combine them in a, for the clinician, useful setting.
Keywords: Biomarker, Biomarker development, Cancer