Multiple immunoreactive inhibin proteins in serum from postmenopausal women with epithelial ovarian cancer

Inhibin is an ovarian protein previously shown, using a nonspecific assay, to be elevated in serum of women with ovarian cancer. However, inhibin is secreted in multiple biochemical forms, including dimeric inhibin A and B and alpha inhibin precursors (pro-alpha C), each of which can now be specifically measured. We have examined the secretion of inhibin B and pro-alpha C inhibin in serum from women with epithelial ovarian cancer (EOC) for the first time, and have compared these analytes to inhibin A and total inhibin (inhibin A + B + pro-alpha C) as potential serum markers for EOC in postmenopausal women. Of all the immunoreactive inhibin proteins studied, the best serum marker was pro-alpha C, with 22% of women with EOC having levels that exceeded the range of values in women without EOC. Since CA 125 and pro-alpha C levels were not significantly correlated, combination of these markers resulted in 87% of EOC cases having elevated preoperative serum levels, a 9% increase over CA 125 alone. These data suggest that alpha inhibin secretion, especially pro-alpha C, may be useful in addition to CA 125 as a serum marker for EOC in postmenopausal women. (C) 1997 Academic Press.