What biomarkers help diagnose ovarian cancer?

David A. Fishman, MD
Gynecologic Oncology
Biomarkers are defined as cellular, biochemical and molecular (including genetic and epigenetic) characteristics by which normal and/or abnormal processes can be recognized and/or monitored. They are measurable in biological materials, such as in tissues, cells and/or bodily fluids. Recognition of these characteristics may be used in screening, early diagnosis, prognosis, tracking treatment response or recurrence of disease.

Among the novel biomarkers for ovarian cancer is human epididymis protein 4 (HE4), which is over-expressed in ovarian cancer. HE4 is combined with cancer antigen 125 (CA125) and used to monitor the progression and recurrence of disease. Similarly kallikreins, which are serine proteases, have been shown to be involved in angiogenesis, tissue invasion and cell growth. Kallikreins have also been used in combination with CA125.

Other potential biomarkers include vascular cell adhesion molecule 1 (VCAM-1), insulin-like growth factor II (IGF-II), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF) and epidermal growth factor receptor (EGF-R). Inflammatory molecules such as cytokines -- for example, interleukin (IL)-8, IL-6 and macrophage colony-stimulating factor (M-CSF) -- facilitate communication between these cells of the tumor microenvironment. Additional biomarkers include prolactin, osteopontin, leptin, lysophosphatidic acid, apolipoprotein A1, transthyretin, COOH osteopontin fragments, and eosinophil-derived neurotoxin.

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