PMC:3431878 / 990-3056
Annnotations
{"target":"http://pubannotation.org/docs/sourcedb/PMC/sourceid/3431878","sourcedb":"PMC","sourceid":"3431878","source_url":"https://www.ncbi.nlm.nih.gov/pmc/3431878","text":"The discovery of CA125 represented a milestone for ovarian cancer detection. In 1981, Bast et al. identified a murine monoclonal antibody, OC125, which reacted almost exclusively with ovarian cancer cell lines and cryo-preserved tissue of ovarian cancer patients [1]. An immuno assay for the detection of the OC125 antigen (CA125) in serum was soon developed and demonstrated a significant correlation between CA125 expression levels and the regression, stability or progression of epithelial ovarian carcinomas [2]. However, elevated serum concentrations were also found in 29% of patients with non-gynecological cancers as well as individuals presenting with benign conditions such as endometriosis, menstruation and pregnancy [2,3]. Due to the lack of specificity of CA125 a risk of malignancy index (RMI) is commonly used in clinical practice which combines CA125 levels, ultrasonographic findings and menopausal status of the patient. Using this approach 85% sensitivity and 97% specificity can be achieved when distinguishing benign from malignant ovarian disease [4]. However, this is not a suitable screening strategy for ovarian cancer as this disease has a low prevalence and requires a specificity of more than 99.6% to achieve an acceptable positive predictive value of 10% [5]. A large randomized controlled trial (RCT) of ovarian cancer screening (OCS) which is ongoing in the United Kingdom, involving 200,000 postmenopausal women (UK Collaborative Trial of Ovarian Cancer Screening, UKCTOCS, www.ukctocs.org) in a multimodality approach, estimates a woman’s risk of ovarian cancer (ROC) [6]. Here, an estimate on the basis of age and modified by the relative fit of the serial CA125 profile to the change-point model estimated from known cases is compared with the flat profile model estimated from known controls. Women who are found to have a high ROC then undergo screening by transvaginal ultrasonography. Preliminary results are promising but it remains unknown if this multimodality screening with CA125 will improve disease specific mortality.","tracks":[{"project":"2_test","denotations":[{"id":"22949880-7028788-50810637","span":{"begin":264,"end":265},"obj":"7028788"},{"id":"22949880-6310399-50810638","span":{"begin":513,"end":514},"obj":"6310399"},{"id":"22949880-6310399-50810639","span":{"begin":730,"end":731},"obj":"6310399"},{"id":"22949880-15726771-50810640","span":{"begin":732,"end":733},"obj":"15726771"},{"id":"22949880-2223684-50810641","span":{"begin":1071,"end":1072},"obj":"2223684"},{"id":"22949880-19282241-50810642","span":{"begin":1604,"end":1605},"obj":"19282241"},{"id":"T12407","span":{"begin":264,"end":265},"obj":"7028788"},{"id":"T98027","span":{"begin":513,"end":514},"obj":"6310399"},{"id":"T29444","span":{"begin":730,"end":731},"obj":"6310399"},{"id":"T65504","span":{"begin":732,"end":733},"obj":"15726771"},{"id":"T91181","span":{"begin":1071,"end":1072},"obj":"2223684"},{"id":"T90021","span":{"begin":1604,"end":1605},"obj":"19282241"}],"attributes":[{"subj":"22949880-7028788-50810637","pred":"source","obj":"2_test"},{"subj":"22949880-6310399-50810638","pred":"source","obj":"2_test"},{"subj":"22949880-6310399-50810639","pred":"source","obj":"2_test"},{"subj":"22949880-15726771-50810640","pred":"source","obj":"2_test"},{"subj":"22949880-2223684-50810641","pred":"source","obj":"2_test"},{"subj":"22949880-19282241-50810642","pred":"source","obj":"2_test"},{"subj":"T12407","pred":"source","obj":"2_test"},{"subj":"T98027","pred":"source","obj":"2_test"},{"subj":"T29444","pred":"source","obj":"2_test"},{"subj":"T65504","pred":"source","obj":"2_test"},{"subj":"T91181","pred":"source","obj":"2_test"},{"subj":"T90021","pred":"source","obj":"2_test"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"2_test","color":"#b993ec","default":true}]}]}}