Serum HE4, CA125, YKL-40, bcl-2, cathepsin-L and prediction optimal debulking surgery, response to chemotherapy in ovarian cancer

• Published in: Journal of ovarian research Vol. 7; no. 1; p. 62
• Main Authors: Chudecka-Głaz, Anita, Cymbaluk-Płoska, Aneta, Menkiszak, Janusz, Sompolska-Rzechuła, Agnieszka, Tołoczko-Grabarek, Aleksandra, Rzepka-Górska, Izabella
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.06.2014; BioMed Central
• Subjects: Adipokines - blood; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - blood; CA-125 Antigen - blood; Cathepsin L - blood; Chitinase-3-Like Protein 1; Cytoreduction Surgical Procedures; Female; Humans; Lectins - blood; Middle Aged; Neoplasm Grading; Neoplasm Staging; Ovarian cancer; Ovarian Neoplasms - blood; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - therapy; Preoperative Period; Prognosis; Proteins; Proto-Oncogene Proteins c-bcl-2 - blood; Reproducibility of Results; ROC Curve; Treatment Outcome; Neoadjuvant chemotherapy; Debulking surgery; HE4; CA125; YKL-40; Cathepsin-L; Ovarian cancer
• ISSN: 1757-2215; 1757-2215
• DOI: 10.1186/1757-2215-7-62

The most important prognostic factor in the ovarian cancer is optimal cytoreduction. The neoadjuvant chemotherapy, an only optional method of treatment in this case and is still the subject of debate. The object of this study was to evaluate the usefulness of markers: CA 125, HE4, YKL-40 and bcl-2 as well as cathepsin L in predicting optimal cytoreduction and response to chemotherapy. Sera were secured preoperatively. The division into groups was performed retrospectively depending on the method of treatment (surgery vs neoadjuvant chemotherapy) as well as on response to chemotherapy (sensitive vs resistant vs refractory). Comparisons were made between groups, and the diagnostic usefulness of tested proteins was examined. We found that statistically significant differences between primary operated patients and patients undergoing neoadjuvant chemotherapy were applicable only to the tumour markers (CA125 1206.79 vs 2432.38, p=0.000191; HE4 78.87 vs 602.45, p=0.000004; YKL-40 108.13 vs 203.96, p=0.003991). Cathepsin-L and Bcl-2 were statistically insignificant. The cut-off point values were determined for the CA 125 (345 mIU/ml), HE4 (218.43 pmol/L) and YKL-40 (140.9 ng/ml). The sensitivity, specificity, PPV and NPV were as follows: CA125 (83.3%; 75%; 80.6%; 78.3%), HE4 (86.6%; 91.3%; 92.9%; 84%) and YKL-40 (75%; 83.3%; 84%; 74.1%). Among the tested proteins the HE4 marker appears to be helpful in forecasting of optimal cytoreduction and possibly also of the prediction of response to platinum analogues used in first-line treatment of ovarian cancer.