Novel risk models for early detection and screening of ovarian cancer.
Novel risk models for early detection and screening of ovarian cancer.
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DOI：
10.18632/oncotarget.13648
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发表时间：
2017-01-03
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影响因子：
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通讯作者：
Graham RL
中科院分区：
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作者：
Russell MR;D'Amato A;Graham C;Crosbie EJ;Gentry-Maharaj A;Ryan A;Kalsi JK;Fourkala EO;Dive C;Walker M;Whetton AD;Menon U;Jacobs I;Graham RL
卵巢癌（Ovarian cancer，OC）是最致命的妇科癌症。需要早期发现以提高患者生存率。通过分析英国卵巢癌筛查协作试验（UKCTOCS）前瞻性收集的样本中的蛋白Z、纤连蛋白、C反应蛋白和CA 125水平，构建了I型（模型I）和II型（模型II）OC的风险估计模型。模型I比单独使用CA 125更早地识别癌症，潜在的提前时间为3-4年。模型II在比单独使用CA 125更早的阶段（I/II期）检测到许多高级别浆液性癌症，潜在的提前时间为2-3年，并将高风险分配给ROCA算法分类为正常的患者。这项巢式病例对照研究包括从49例OC病例和31例对照中连续收集的418份血清样本，这些样本在诊断前长达6年。结合候选蛋白质的ELISA结果与CA 125水平建立判别性logit模型。这些模型对于检测临床前卵巢癌具有令人鼓舞的灵敏度，与单独的CA 125相比，显示出提高的灵敏度。此外，我们还展示了模型如何在某些情况下改善ROCA，并概述了其作为临床工具的潜在未来用途。
Ovarian cancer (OC) is the most lethal gynaecological cancer. Early detection is required to improve patient survival. Risk estimation models were constructed for Type I (Model I) and Type II (Model II) OC from analysis of Protein Z, Fibronectin, C-reactive protein and CA125 levels in prospectively collected samples from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). Model I identifies cancers earlier than CA125 alone, with a potential lead time of 3-4 years. Model II detects a number of high grade serous cancers at an earlier stage (Stage I/II) than CA125 alone, with a potential lead time of 2-3 years and assigns high risk to patients that the ROCA Algorithm classified as normal. This nested case control study included 418 individual serum samples serially collected from 49 OC cases and 31 controls up to six years pre-diagnosis. Discriminatory logit models were built combining the ELISA results for candidate proteins with CA125 levels. These models have encouraging sensitivities for detecting pre-clinical ovarian cancer, demonstrating improved sensitivity compared to CA125 alone. In addition we demonstrate how the models improve on ROCA for some cases and outline their potential future use as clinical tools.