Determining the Diagnostic Strength of Serum Tumor Markers in Epithelial Ovarian Cancer in Women from Lahore, Pakistan

Background: Ovarian cancer is tagged as deadly condition worldwide. The delay in diagnose is due to late presentation and lack of specific screening tests. HE4 and CA15-3 are considered as noninvasive marker with varied cut off reference and sensitivity, specificity among various populations. Objective: The objective of this study was to investigate correlation along with sensitivity, specificity, PPV, NPV of HE4, CA15-3 and CA125 among epithelial ovarian cancer. Methods: This cross section comparative study was conducted on 70 diagnosed ovarian cancer cases age 20 to >= 70 year of any FIGO stage I-IV after approval from IRB and ethical review board (UHS/Reg-17/ERC-4659) of University of Health Sciences. The blood samples were taken and serum levels of HE4 and CA15-3 were measured by ELISA. While CA125 was determined from patient investigation reports. Results: This study found positive correlation (r=0.089 p=0.66) between malignant and borderline ovarian tumors for HE4, while negative correlation between early (I and II) and advanced (stage III and IV) FIGO stage with r=-0.028 p=0.876. Whereas, for CA15-3 negative correlation was observed with r=-0.006 p=0.980 between malignant and borderline variants of epithelial ovarian cancer and also negative correlation was seen between early (I and II) and advanced (stage III and IV) FIGO stage with r=-0.095 p=0.588. Conclusions: The discriminative strength of HE4 as biomarker determined by ROC curve was 0.55%. Hence HE4 can be used for diagnosis or prognosis of ovarian cancer.