Results from a recent study published in the Journal of Clinical Oncology indicate that a new blood marker, YKL-40, may detect early stages of ovarian cancer with improved accuracy over the standard markers.
Ovarian cancer is a malignancy that arises from various different cells within the ovaries. Approximately 25,000 new cases of ovarian cancer are diagnosed in the United States each year. Unfortunately ovarian cancer often goes undetected until the disease has progressed into the abdomen or spread to other organs. Because advanced ovarian cancer is often associated with poor outcomes and early ovarian cancer is associated with significantly improved survival, a great deal of research is being done to explore how ovarian cancer could be detected earlier.
Currently, there are two blood markers for detecting ovarian cancer, CA-125 and CA-15-3. These markers are antigens (proteins) produced by the tumor cells and shed into the bloodstream. They are good indicators of cancer activity within the body. These markers are used to help detect ovarian cancer, as well as determine the effectiveness of treatment and disease progression in patients with advanced ovarian cancer. One issue with these markers is that cancer often cannot be detected until the disease has reached advanced stages, and/or levels may be elevated in situations other than ovarian cancer, such as pregnancy, non-cancerous conditions, or other cancers other than that of the ovary. Researchers are continuing to evaluate novel markers to improve upon early detection, as well as improve upon the accuracy of these markers.
Researchers from New York recently conducted a clinical study to compare a new marker, YKL-40, to the standard markers CA-125 and CA15-3 in the detection of ovarian cancer. This study included 190 women: 50 women who had been diagnosed with early ovarian cancer; 61 women who were at a high risk of developing ovarian cancer; 33 women with non-cancerous gynecologic conditions; and 46 women who were healthy. Of the group of patients already diagnosed with ovarian cancer, 65% had elevated YKL-40 levels, while only 26% had elevated CA-125 levels, and only 13% had elevated CA15-3 levels. YKL-40 levels were highest in women with ovarian cancer and lowest in women who were healthy. In addition, higher YKL-40 levels (greater than 80 ng/mL) among the group of women with ovarian cancer conferred a significantly worse prognosis, compared to women with a lower YKL-40 level (71% recurrence vs. no recurrence, respectively).
The researchers concluded that YKL-40 may be a promising new marker in ovarian cancer, appearing to provide greater accuracy for early detection of ovarian cancer as well as long-term prognosis for patients already diagnosed with ovarian cancer, compared to CA-125 or CA15-3 markers. However, further studies are required to provide definitive results and move YKL-40 into standard clinical practice. Patients at a high risk of developing ovarian cancer or those who have been diagnosed with ovarian cancer may wish to speak with their physician about the risks and benefits of participating in a clinical trial to further evaluate YKL-40 or other novel markers.
Reference: Dupont J, Tanwar M, Thaler H, et al. Early Detection and Prognosis of Ovarian Cancer Using Serum YKL-40. Journal of Clinical Oncology. 2004; 22: 3330-3339.