Algorithms Used in Ovarian Cancer Detection: A Minireview on Current and Future Applications

Abstract

Background Ovarian cancer is the 5th most common cause of cancer death among women in the US. Currently, there is no screening algorithm for asymptomatic women that has been shown to lower mortality rates. Screening is currently not recommended and has been shown to increase harm. Epithelial ovarian cancer (EOC) detection is reviewed, with a focus on high-grade serous, clear-cell, and endometrioid histotypes. Content A review of current literature surrounding tools used in detection of ovarian cancer will be presented. CA 125, HE4, risk of ovarian cancer algorithm (ROCA), risk of malignancy algorithm (ROMA), risk of malignancy (RMI), OVA1, and future potential biomarkers are reviewed. Summary Screening and early identification of EOC is currently managed as a single disease entity. However, recent evidence has shown ovarian cancer varies with relation to cellular origin, pathogenesis, molecular alterations, and prognosis, depending on histotype. There is a clear need for future studies identifying histotype-specific preclinical tumor markers to aid in detection and improvement of survival rates.

Diagnostic potential of nanoparticle aided assays for MUC16 and MUC1 glycovariants in ovarian cancer

“…11 For this reason, supplementary biomarkers to CA125, such as HE4 12 or multimodal diagnostic tests and algorithms (ROMA, ROCA, OVA1 and Overa) with CA125 as the key component have been proposed. 7,13,14 In the United Kingdom, a large prospective EOC screening study (UKCTOCS) combined ultrasound and serial CA125 measurements, with results suggesting that this strategy could improve early detection and reduce disease mortality. 15 However, the UK National Screening Committee (UKNSC) did not recommend it for systematic population screening in its July 2017 report.…”

“…Immunoassays (IA) of CA125/MUC16 was the first and to date the most well‐documented serum marker for EOC differential diagnosis, progression and for monitoring of therapy response 5,6 . However, high concentrations are also found in benign gynecological conditions (ie, endometriosis, pregnancy, heart failure, menstruation and pelvic inflammatory disease) 7,8 as well as in a wide range of other malignant carcinomas (colorectal, breast, lung, liver, gastric and pancreatic) 9,10 . The inadequate specificity of CA125 impedes its use for early‐stage EOC diagnosis and disease progression 11 .…”

Novel Optical Biosensor Based on a Nano-Gold Coated by Schiff Base Doped in Sol/Gel Matrix for Sensitive Screening of Oncomarker CA-125

“…2 Extensive efforts were exerted by scientists and gynecologists worldwide for the sake of the early diagnosis of OC and implementing different effective screening strategies to improve the survival rates. 3,4 Up to date, cancer antigen (CA-125), also termed mucin 16 or carbohydrate antigen, has been considered to be the most popular tumor marker and the gold standard in OC in all aspects, since its discovery in 1981. 5−7 The CA-125 normal cutoff range is 0−35 U mL −1 , and nearly 90% of women suffering from epithelial OC (EOC) exhibit raised serum levels.…”

“…Unfortunately, CA-125 level could also be elevated in various physiological conditions such as pregnancy and menstruation, in addition to pathological conditions including benign cases and non-OCs. 4 Despite the low specificity, the utility of CA-125 as a diagnostic biomarker in OC diagnosis is still significant where it could be recruited using advanced trends. Among these trends, one approach adopted statistical and arithmetic algorithms as significant tools for the diagnosis and discrimination between malignant and benign ovarian tumors as the risk of malignancy index, risk of malignancy algorithm, multivariate index assay, and the risk of OC algorithm, known as RMI, ROCA, OVA1, and ROMA, 3 respectively.…”

“…The CA-125 normal cutoff range is 0–35 U mL –1 , and nearly 90% of women suffering from epithelial OC (EOC) exhibit raised serum levels. Unfortunately, CA-125 level could also be elevated in various physiological conditions such as pregnancy and menstruation, in addition to pathological conditions including benign cases and non-OCs …”