STIP1，HE4 and CA125 diagnostic performances for ovarian cancer

ADZABE Luckresse，CAI Yu lang

(Department of Gynecology and Obstetrics，Zhongda Hospital， Southeast University，Nanjing 210009，China)

1 CA125 biomarker

CA125 was firstly identified in 1981 as a protein elevated in the serum of women diagnosed with ovarian cancer[3].Its the most widely used biomarker for ovarian cancer.Most oncologists recommend to use CA125 for the differential diagnosis of a suspected pelvic mass， monitoring efficacy of treatment and detection of recurrence of ovarian cancer[4].CA125 diagnosis sensitivity is low, it is about 50% in stage 1 ovarian cancer’s patients and 80%-90% in stage Ⅱ-Ⅳ[5],in addition 20% of epithelial ovarian cancers do not expressed CA125[6].Through the years we have realized that CA125 is frequently elevated in many gynecology and non gynecology pathological conditions such as endometriosis and adenomyosis， pelvic，peritoneal，musculoskeletal inflammatory diseases，hepatitis pancreatitis，liver cirrhosis，even physiological conditions such as menstruation or pregnancy can be associated with elevated CA125(>35 U·ml-1).If we considered CA125 as a single marker to diagnose ovarian cancer， then its positive predictive value is less than 10%，but this value was improved by imaging diagnostics methods[7].Because CA125 level is not raised in all patients with benign ovarian tumor and is not significantly express in tissues[8]，therefore neither symptoms nor CA125 alone can be safely used as instruments to discriminate or differential women with malignant ovarian tumors from women with benign ovarian tumors. Biomarkers with higher sensitivity and specificity then CA125 to detect early stage of ovarian cancer are needed and will complete CA125 diagnostic performances for ovarian cancer.

2 HE4 biomarker

3 STIP1 Biomarker

4 HE4 vs CA125 diagnostic performances for ovarian cancer

5 STIP1 and HE4 diagnostic performances for ovarian cancer

6 Conclusion

There is evidence that HE4 overcomes CA125 in terms of diagnostic performance in the identification of ovarian cancer for women with suspected gynecological disease. On the other hand，STIP1 diagnostic performances seem to be superior to HE4 and CA125. STIP1 pathway may represent a novel therapeutic target for human ovarian cancer[33].Its very important to understand more about the risks of having a high level of these three markers，also to study and compare the expression of this markers between different population and geographies．

[20] PITTA D R，SARIAN L O，BARRETA A，et al.Symptoms，CA125 and HE4 for the preoperative prediction of ovarian malignancy in Brazilian women with ovarian masses[J].BMC Cancer，2013，13:423．

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