Saliva and serum CA 125 assays for detecting malignant ovarian tumors

Article Abstract:

High levels of CA 125 (a protein) in the blood have been observed in association with epithelial ovarian cancer. Consequently, measurement of this substance is now a way of detecting ovarian cancer. However, CA 125 is also present in saliva; such measurements would involve less invasive procedures than a blood test. To establish average CA 125 levels in various conditions, the protein was measured in blood and saliva in gynecologic patients with and without cancer and healthy women. The subjects included female blood donors (55 people); patients with benign pelvic masses (92); and patients with malignant pelvic tumors (41). The results showed differences between the groups in the CA 125 levels detected, with a sensitivity (number of true positives divided by the sum of true positives and false negatives) of 81.3 and 93.8 percent for the saliva and blood assays, respectively, in the ovarian cancer patients. Neither assay was positive for the patients with benign disease and the healthy women. There was no significant difference in intertest sensitivity, but specificity (true negatives divided by the sum of true negatives and false positives), diagnostic efficiency, and positive predictive value (true positives divided by the sum of true and false positives) for the saliva assays were better than those for the blood assays. The false-positive rates of between 10 and 13.6 percent for patients with ovarian endometriomas and pelvic tuberculosis (benign masses) for the saliva test are improvements over the rates of 72.7 and 80 percent, respectively, for the blood test. It thus appears that the determination of salivary CA 125 levels is a feasible, noninvasive approach in the diagnosis of ovarian cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Saliva, Blood chemical analysis, blood

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Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy

Article Abstract:

Sonography or ultrasound (US) is a diagnostic imaging technique that uses high frequency sound waves to develop images of internal structures. A number of studies have evaluated its use in identifying different types of ovarian disease. This study examined a scoring system, based on findings from transvaginal US, to characterize ovarian disease with the major purpose of distinguishing malignant (cancerous) from nonmalignant disease. The study reviewed the sonograms of 143 patients with ovarian disease who had surgical diagnosis within three months of the US examination. The sonograms were scored and compared with the surgical results. Scores between 5 and 13 were evaluated for sensitivity (detecting disease where it exists) and specificity (not detecting disease where it does not exist). Results showed that 13 patients had malignant disease involving 20 ovaries. Fourteen of the ovaries scored 9 or higher on US findings. Nine ovaries were not visualized on sonography as ovaries because of bilateral disease, or disease affecting both ovaries. All the malignant ovaries appeared abnormal on US. Two abnormal ovaries that were not malignant had scores greater than nine. The sensitivity was 100 percent and the specificity was 83 percent for the scoring system when a score of nine or greater was used to indicate malignant disease. These results demonstrate that a scoring system for ovarian malignancy, based on transvaginal US findings, can be very useful and accurate. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Ultrasound imaging

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Intraoperative radioimmunodetection of ovarian cancer using monoclonal antibody B72.3 and a portable gamma-detecting probe

Article Abstract:

Antibodies that recognize molecules specific to cancerous cells can be produced in the laboratory using monoclonal techniques. These monoclonal antibodies, when tagged with radioactivity, can be used during surgery to identify small groups of cancerous cells that would otherwise escape recognition. The effectiveness of radioimmunoguided surgery was assessed in 13 women who had received previous treatment for ovarian cancer. Of seven patients who had demonstrable cancer in biopsies and who could be evaluated by the technique, four had positive results using the monoclonal probe, giving a sensitivity of 57 percent (identifies those with cancer). Some cancers may have been missed because the types of cancerous cells may have changed following chemotherapy. True negative readings were detected in 7 of 10 patients, yielding a specificity of 70 percent (identifies those without cancer). Computed tomography scans were done in 11 patients and failed to detect cancerous growths as large as three centimeters. The results suggest that the monoclonal probe may be more useful for identifying cancerous cells than frozen section biopsy examination, a quick method of cell analysis used during surgery. Further refinement of the intraoperative immunodetection technique is needed to improve its effectiveness in identifying cancerous cells. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Radioimmunoimaging

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