Biomarkers in Ovarian Pathology: From Screening to Diagnosis. Review of the Literature.

BACKGROUND: Ovarian cancer has a low incidence, but high mortality due to a habitual diagnosis in advanced cancer stages. Currently, used biomarkers have good sensitivity, but low specificity. AIM: To determine the usefulness of the biomarkers and algorithms used up to now in the screening, diagnosis, response to treatments and identification of recurrence in patients with ovarian masses. METHODOLOGY: Systematic search of publications in English in the Medline-PubMed database with the terms: "biomarkers", "tumour", "tumour biomarkers", "marker", "tumour marker", "ovarian cancer", "ovarian", "Neoplasms", "cancer", CA-125 Antigen; Human Epididymis-specific Protein E4; Risk of Malignancy Index (RMI); Risk of Ovarian Malignancy Algorithm (ROMA); Ovarian Neoplasms. Original articles, clinical trials, reviews, systematic reviews and meta-analyses, published between January 2000 and November 2020, were selected to determine the usefulness (among others) of CA 125 and HE4 antigen in ovarian cancer. RESULTS: Finally, 39 transcendental publications were selected to write this article to determine the usefulness of tumour markers and algorithms in ovarian cancer. CONCLUSIONS: The usefulness of the tumour markers antigen CA125 and antigen HE4 individually or as a basis for decision-making algorithms has low specificity; however, there is little evidence that confirms their usefulness as markers in ovarian cancer screening.

Involvement of G-463A MPO gene polymorphism in the response of postmenopausal women to hormone therapy.

OBJECTIVE: The aims of this work were to determine (1) the effects of estrogen plus progestogen therapy (EPT) and raloxifene on oxidative stress and cardiovascular risk biomarkers in postmenopausal women and (2) the involvement of the functional G-463A polymorphism of the myeloperoxidase (MPO) gene in the therapy responses. METHODS: Postmenopausal women (45-55 y old) were assigned to three groups receiving (1) EPT (continuous 50 µg transdermal estradiol daily and 200 mg/d micronized progesterone orally the first 14 d of each month; n = 21), (2) raloxifene (60 mg daily; n = 17), and (3) no treatment (control; n = 21). Blood and urine samples were taken before and after 6 months of therapy. Measurements were serum lipid profile, C-reactive intercellular adhesion molecule 1 (ICAM-1), α-tocopherol, γ-tocopherol, uric acid, total antioxidant activity (TAA), malondialdehyde, and urinary 1,4-dihydroxynonane-mercapturic acid (the major urinary 4-hydroxynonenal metabolite). The G-463A MPO polymorphism was analyzed by polymerase chain reaction and restriction fragment length polymorphism. RESULTS: EPT significantly decreased TAA and the levels of ICAM-1, not modifying other cardiovascular risk or oxidative stress markers. The raloxifene and control groups experienced no modifications in oxidative stress or endothelial dysfunction markers. The MPO genotype specifically influenced the outcomes in the EPT group. Thus, TAA decreased significantly in GG (high-expression genotype) homozygotes, whereas ICAM-1 levels were reduced in A allele carriers. CONCLUSIONS: EPT exerted a negative action on the serum oxidant/antioxidant balance in the MPO GG homozygotes and a positive effect on the ICAM-1 endothelial dysfunction marker in carriers of the low-expression A allele. This observation provides evidence of the importance of this polymorphism in the response to EPT.

Terapia hormonal renacida: algunos interrogantes / Hormone therapy reborn: some unterrogantes

La transición menopáusica es un período de capital importancia en la vida de la mujer para determinar cuál será su salud en los años siguientes de la madurez y la senilidad. La terapia hormonal ha pasado de ser la panacea en el mantenimiento de la eterna juventud a ser abandonada casi por completo por los proveedores de salud en general. Los reanálisis de los grandes ensayos clínicos sobre terapia hormonal de la menopausia nos proporcionan la oportunidad de reflexionar sobre el carácter integral que debe presidir nuestra asistencia médica en este período de la historia vital de la mujer...

[General recommendations over perimenopausal transition therapy]. / Recomendaciones generales para el tratamiento en la transición perimenopáusica.

BACKGROUND: Medical attention during perimenopause requires different therapeutic strategies. OBJECTIVE: To define strategies for the attention of perimenopause women that can favor a healthy aging. METHODS: Review of influencing factors and lifestyle modifications that can be introduced in perimenopause to prevent pathologies. RESULTS: Diet composition and weight control influence cardiovascular and bone risks. It is difficult to get permanent changes in diet habits and there is a lack of conclusive evidence over the results of these recommendations, however there begin to arise better works that shows cardiovascular and osseous benefits of physical activity and specific exercise schedules. Due to them higher risk, it is necessary to suppress toxic habits. Several studies suggest phytotherapeutic supplements consumption benefit, however there is a lack of well-designed clinical essays to justify them recommendation. CONCLUSIONS: Correct nutritional state, appropriate diet, weight control, a common exercise practice, and suppression of toxic habits are applicable measures during perimenopause transition that could influence woman's health level for them lifespan. Individualized identification of diseases risk can justify the recommendations.