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In Search of the Ideal Tumor Marker for Epithelial Ovarian Cancer: Serum Antigen CA-125 versus HE4, and Others; Current Status and Clinical Utility

January-March 2014, Volume 01, Number 1
Flavia Morales-Vásquez, Horacio Noé López-Basave, Carmen Méndez, Dolores Gallardo-Rincón, Claudia Cano-Blanco, Wendy R. Muñoz, José Luis Aguilar-Ponce and Jaime G. de la Garza-Salazar
Department of Medical Oncology, National Cancer Institute, Mexico City, Mexico

Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy; it primarily affects postmenopausal women, and the average age of onset is between 55 and 65 years in the USA. The prevalence is one in 2,500 postmenopausal women. We don´t have ideal strategies for prevention and detection, and 80% of cases are locally advanced disease. A variety of biomarkers have been developed to monitor growth. CA-125 (MUC 16) has provided a useful serum tumor marker for monitoring the efficacy of cytotoxic chemotherapy and the early detection of relapse during the follow-up of patients. Twenty per cent of all cases have little or no expression of CA-125 and it is necessary to explore new markers for early disease or screening. Several algorithms have been developed that calculate the risk of ovarian cancer on serial CA-125 values and refer patients at highest risk for transvaginal sonography, but the strategy is limited. More than 30 serum markers have been evaluated alone and in combination with CA-125 by different investigators. Some of the most promising include: HE4, mesothelin, M-CSF, osteopontin, kallikreins, and the soluble growth factor receptor. In this review, we describe the actual status of CA-125, new strategies for early detection, and the utility of the new markers in this disease.

Key words:
Ovarian cancer. Serum marker. CA-125. HE4.
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