Status of tumor markers in epithelial ovarian cancer has there been any progress? A review

ObjectiveThe aim is to present an overview of tumor markers other than CA-125 that have been proposed for use in the diagnosis of epithelial ovarian cancer and explore molecular studies which have been used to identify genomic and proteomic changes associated with this malignancy for possible future development of more sensitive tumor markers.MethodsA Medline search was conducted to review published articles from American and European studies from 1990 to 2010, related to tumor markers for ovarian cancer. Different methods such as genomic, proteomic and transcriptional profiling were used to identify new tumor markers for clinical use.ResultsA few of the newer tumor markers alone have demonstrated equal or slightly higher sensitivity to CA-125. Improved sensitivity and specificity have been reported using these new markers combined with CA-125.ConclusionAddition of new tumor markers as a compliment to CA-125 were associated with higher sensitivity and detection rates than either marker alone. However, the low prevalence of ovarian cancer necessitates a higher level of sensitivity and specificity that has still not been achieved if these biomarkers are used for diagnosis and monitoring the disease progress as a result of low positive predictive value.

Research Highlights
► Improved sensitivity, specificity and detection rate when new tumor markers combined with CA-125 is presented.
► It appears that HE4 and mesothelin are the most promising new markers which are under clinical investigation.