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Microvesicle proteomics of 187 utero-tubal lavage samples for early diagnosis of HGOC.• Machine learning-based classification of a 9-protein signature with high predictive power.• Signature has 70% sensitivity and 76.2% specificity, predicting stage I lesions.

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Although not significant, BRCA mutation carriers tended to have more advanced disease at diagnosis. However, the survival was similar irrespective of the BRCA status in this small group. Further research is needed to confirm these findings in a larger cohort.