Two-marker Combinations for Preoperative Discrimination of Benign and Malignant Ovarian Masses

Background: When caring for patients with ovarian neoplasms, correct preoperative discrimination of benign and malignant disease is deemed vital. In this study, we tested serum biomarkers' alone and in combination, to achieve this aim. Materials and Methods: We measured the concentrations of Cancer Antigen (CA)-125, CA15-3, CA27-29, Carcinoembryonic Antigen (CEA), CA19-9, human chorionic gonadotropin (hCG), Placental Protein (PP)1490, CA72-4, galectin-3, galectin-1 and Human epididymis protein (HE)4 in sera of 133 patients with pelvic masses by ELISA and correlated the results to subsequent histology. We used the area under the curve (AUC) of biomarkers and their combinations and calculated the 95% confidence intervals by using casewise resampling. Results: The best single biomarkers were CA-125 (sensitivity and AUC) and HE4 (specificity). Combinations with HE4 and CA 19-9 improved the predictive power of CA-125. The best discrimination was achieved by the combination of CA-125 and HE4, with an AUC of 0.961. Conclusion: A combination of CA-125 with HE4 could facilitate the identification of women at risk for ovarian cancer.