CA 125: The past and the Future

Bast, Robert C.; Xu, Feng; Yu, Yinhua; Barnhill, S.; Zhang, Z.; Mills, Gordon B.

doi:10.1177/172460089801300402

Cited by 388 publications

(270 citation statements)

References 31 publications

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“…Although a number of tumour markers have been identified (Bast et al, 1987;Berek and Bast, 1995;Mackey and Creasman, 1995;Chen and Karlan, 1998), a useful screening marker for ovarian cancer has not yet been clearly established. The most widely used marker, CA125, has shown merit in pilot screening studies and ovarian cancer management, but the sensitivity for early-stage disease before clinical detection remains questionable (Bast et al, 1998). We have previously identified by differential display a cDNA that is highly expressed in ovarian tumour (Anisowicz et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Characterisation of human kallikrein 6/protease M expression in ovarian cancer

Zhang

Huang

et al. 2004

Br J Cancer

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Kallikrein 6 (hK6, also known as protease M/zyme/neurosin) is a member of the human kallikrein gene family. We have previously cloned the cDNA for this gene by differential display and shown the overexpression of the mRNA in breast and ovarian primary tumour tissues and cell lines. To thoroughly characterise the expression of this kallikrein in ovarian cancer, we have developed a novel monoclonal antibody specific to hK6 and employed it in immunohistochemistry with a wide range of ovarian tumour samples. The expression was found elevated in 67 of 80 cases of ovarian tumour samples and there was a significant difference in the expression levels between normal and benign ovarian tissues and the borderline and invasive tumours (Po0.001). There was no difference of expression level between different subtypes of tumours. More significantly, high level of kallikrein 6 expression was found in many early-stage and low-grade tumours, and elevated hK6 proteins were found in benign epithelia coexisting with borderline and invasive tissues, suggesting that overexpression of hK6 is an early phenomenon in the development of ovarian cancer. Quantitative real-time reverse transcription -polymerase chain reactions also showed elevated kallikrein 6 mRNA expression in ovarian tumours. Genomic Southern analysis of 19 ovarian tumour samples suggested that gene amplification is one mechanism for the overexpression of hK6 in ovarian cancer.

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Section: Discussionmentioning

confidence: 99%

Characterisation of human kallikrein 6/protease M expression in ovarian cancer

Zhang

Huang

et al. 2004

Br J Cancer

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“…MUC16/CA125 is an established diagnostic marker for ovarian carcinoma and is being routinely used in clinics. 29 IHC analyses demonstrated differential expression profiles of MUC1, MUC4 and MUC16 (Table 1). Of the total 63 ovarian tumor samples, 30.0, 46.0 and 6.0% samples showed þ 1, þ 2 and þ 3 intensity grade immunoreactivity for MUC1, respectively, with a mean composite score of 3.1770.34 (Table 1).…”

Section: Comparative Immunoprofiling Of Muc1 Muc4 and Muc16 In Ovarimentioning

confidence: 99%

Aberrant expression of MUC4 in ovarian carcinoma: diagnostic significance alone and in combination with MUC1 and MUC16 (CA125)

et al. 2006

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Mucins are being implicated in diagnosis, prognosis, and as therapeutic targets due to their aberrant expression in a variety of carcinomas. Here, we have analyzed the expression of MUC4 and have compared its potential usefulness in early detection and prognosis of ovarian carcinoma alone and in combination with other mucin antigens, MUC1 and MUC16. Clinical significance of the differential mucin expression was evaluated by grouping the tumor samples in early (stage I and II) and advanced (stage III and IV) stage cases and histological subtypes (serous, mucinous, endometrioid and clear cell). Correlation of these mucins with patient's survival (n ¼ 63) was determined by Kaplan-Meier analysis in order to predict their prognostic value. MUC4 showed significant overexpression in tumor cases (Po0.0001) with highest incidence (92.0%) among all three mucins. A significant overexpression of MUC1 (Po0.018) and MUC16 (Po0.0001) was also observed in 83.0 and 79.0% of tumor samples, respectively. Notably, MUC4 expression was significantly higher (Pr0.004) compared to both MUC1 and MUC16 in early-stage ovarian tumor samples with 100% incidence. In advanced stage ovarian tumors, all the mucins displayed overall comparable expression, nonetheless, MUC4 had highest prevalence (88.0%) compared to MUC1 (84.0%) and MUC16 (81.0%). A combined panel of MUC4 with MUC16 detected 100% of the late-stage tumor cases without compromising the specificity. Among histological subtypes, only MUC4 displayed 100% (n ¼ 5) sensitivity in mucinous ovarian tumors, while MUC1 and MUC16 detected 40 and 20% cases, respectively. The expression of MUC4, however, did not significantly correlate with the survival of the ovarian cancer patient, while a significant correlation of MUC16 with poor prognosis was observed. In conclusion, our study demonstrates that MUC4 could be a potential candidate marker for early diagnosis of epithelial ovarian carcinoma and can be utilized in combination with MUC16 to achieve greater sensitivity for the detection of late-stage tumors.

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“…These epitopes are also detected in fetal coelomic epithelium, muUerian duct remnants, amnion and amniotic fluid. CA 125 antigenic determinants are not found in normal adult ovarian tissues but are associated with epithelial ovarian carcinoma (11)(12)(13)(14)(15)(16)(17).…”

Section: Cancer Antigen 125 (Ca 125)mentioning

confidence: 99%

Application of tumor markers in ovarian malignancies

Malati

Kumari

Yadagiri

2001

Indian J Clin Biochem

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Ovarian cancer is the fifth leading cause of death in women. The incidence of this malignancy increases in women over the age of 40. The overall five years survival is less than 30%, as most women present with advanced stage disease. Until recently, detection of early stage ovarian cancer has been difficult since it is usually nonpalpable and asymptomatic. The definitive diagnosis of an ovarian mass is a common problem in gynecologic patients with adnexal mass. The routine standard evaluation for adnexal masses includes patient's history, physical examination, ultrasound and histopathological examination. These parameters individually or in combination have little predictive value. The accuracy of diagnostic tools are of immense value and great concern to practicsing Gynecologists and Oncologists. The clinical application of serum concentration of CA 125, AFP and hCG is of great help not only as diagnostic aid but also in monitoring efficacy of any treatment modality like chemotherapy, radiotherapy or surgical resection. Additionally, evaluation of tumor marker concentration helps in predicting early biochemical recurrence and in prognostication in different types of ovarian malignancies. The ability to differentiate a malignant mass from a benign pelvic mass pretherapeutically could be enhanced optimally by additional use of tumor markers such as cancer antigen CA-125, alphafetoprotein and human chorionic gonadotrophin in pre-and postmenopausal women.

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CA 125: The past and the Future

Cited by 388 publications

References 31 publications

Characterisation of human kallikrein 6/protease M expression in ovarian cancer

Characterisation of human kallikrein 6/protease M expression in ovarian cancer

Aberrant expression of MUC4 in ovarian carcinoma: diagnostic significance alone and in combination with MUC1 and MUC16 (CA125)

Application of tumor markers in ovarian malignancies

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