Oncology biomarkers for gynecologic malignancies
Janos L. Tanyi1, Nathalie Scholler2
1
Division of Gynecologic Oncology, University of Pennsylvania Health System, 2Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health, Penn Ovarian Cancer Research Center, University of Pennsylvania School of Medicine, Philadelphia, PA
TABLE OF CONTENTS
- 1. Abstract
- 2. Introduction
- 3. Biomarkers of gynecologic malignancies currently used in clinics
- 3.1. Ovarian cancer
- 3.1.1. Markers of epithelial ovarian cancers (EOC)
- 3.1.1.1. CA125 (MUC16)
- 3.1.1.2. Composite markers for EOC
- 3.1.1.3. Human Epididymis Protein 4 (HE4)
- 3.1.2. Markers of Non-Epithelial Ovarian Cancers (non-EOC)
- 3.1.2.1. Human Chorionic Gonadotropin (hCG)
- 3.1.2.2. Serum alpha-fetoprotein (sAFP)
- 3.1.2.3. Inhibin and activin
- 3.2. Cervical cancer
- 3.2.1. Squamous-cell carcinoma antigen (SCC-Ag)
- 3.2.2. CA125
- 3.3. Endometrial cancer
- 4. Biomarkers of gynecologic malignancies under study
- 4.1 .Ovarian Cancer
- 4.1.1. Mesothelin
- 4.1.2. Lysophosphatidic acid (LPA)
- 4.1.3. Osteopontin (OPN)
- 4.1.4. Kallikreins (KLK)
- 4.1.5. Risk models and screening algorithms
- 4.2. Cervical cancer
- 4.2.1. Carcinoembryonic antigen (CEA)
- 4.2.2. CYFRA 21-1
- 4.3 .Endometrial cancer
- 4.3.1. Human epididymis protein 4 (HE4)
- 4.3.2. Kallikreins
- 4.3.3. Serum amyloid A (SAA)
- 4.3.4. CA72-4 and CA19-9
- 5. Summary and perspective
- 6. Acknowledgements
- 7. References
1. ABSTRACT
Current therapies efficiently treat most patients with gynecologic
malignancies detected at an early stage. Thus, the identification of oncology biomarkers for screening and monitoring of occult tumors has been highly prioritized. Hyperglycosylated human chorionic gonadotropin (hCG) epitomizes oncologic biomarker, as the serum level of this hormone is elevated in virtually all cases of gestational trophoblastic diseases. On the other hand, despite the availability of various markers such as CA125, CA19.9, CA15.3, CA72-4, Inhibin, beta-hCG, AFP, CEA and many more biomarkers under investigation, fewer than 25% of all ovarian cancers are currently detected in stage I. Large efforts have been undertaken to further identify composite markers for gynecologic malignancies that may exhibit greater specificity when studied over time, as well as to develop risk models and screening algorithms aimed at improving the specificity and sensitivity of diagnostic tests. In this review, we provide a comprehensive analysis of the biomarkers currently used in clinics for gynecologic malignancies, as well as an outlook of the most promising oncologic biomarkers currently under study.
