Ovarian cancer early detection by circulating CA125 in the context of anti-CA125 autoantibody levels: Results from the EPIC cohort
Ovarian cancer early detection by circulating CA125 in the context of anti-CA125 autoantibody levels: Results from the EPIC cohort
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DOI：
10.1002/ijc.31164
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发表时间：
2018-04-01
影响因子：
6.4
通讯作者：
Kaaks, Rudolf
中科院分区：
文献类型：
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作者：
Fortner, Renee T.;Schock, Helena;Kaaks, Rudolf
CA125是迄今为止最好的卵巢癌早期检测标记物；然而，敏感性有限，需要补充标记物来提高对卵巢癌病例和非病例的区分。循环中观察到抗CA125自身抗体。我们的目标是评估这些抗体(1)是否可以作为早期检测标记物，提供对正在发展的肿瘤的免疫反应的证据，以及(2)通过掩盖CA125水平(导致更低的分辨率)或协同作用来改善病例和非病例之间的分辨率来改变CA125的区分能力。我们使用欧洲癌症和营养队列前瞻性调查(EPIC)中的嵌套病例对照研究对这些目标进行了调查，其中包括在采血后4年内确诊的250例病例和最多4名匹配的对照。用电化学发光法测定循环CA125抗原和抗体水平。调整后的曲线下面积(AAUC)按两年的滞后时间间隔计算，使用条件Logistic回归进行校正，以先前存在的流行病学风险模型的绝对风险估计值作为补偿变量。仅抗CA125水平并不能区分病例和对照组。对于被诊断为
CA125 is the best ovarian cancer early detection marker to date; however, sensitivity is limited and complementary markers are required to improve discrimination between ovarian cancer cases and non-cases. Anti-CA125 autoantibodies are observed in circulation. Our objective was to evaluate whether these antibodies (1) can serve as early detection markers, providing evidence of an immune response to a developing tumor, and (2) modify the discriminatory capacity of CA125 by either masking CA125 levels (resulting in lower discrimination) or acting synergistically to improve discrimination between cases and non-cases. We investigated these objectives using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort (EPIC) including 250 cases diagnosed within 4 years of blood collection and up to four matched controls. Circulating CA125 antigen and antibody levels were quantified using an electrochemiluminescence assay. Adjusted areas under the curve (aAUCs) by 2-year lag-time intervals were calculated using conditional logistic regression calibrated toward the absolute risk estimates from a pre-existing epidemiological risk model as an offset-variable. Anti-CA125 levels alone did not discriminate cases from controls. For cases diagnosed