RESUMEN
OBJECTIVE: Early detection through regular screening could significantly reduce mortality from ovarian cancer. Advances in biomarkers and imaging continue to improve the sensitivity and specificity of cancer detection, but further improvements are still needed. In this study, we identified and evaluated three new serum biomarkers that may be used to improve detection of ovarian cancer. METHODS: Through genomic analysis, we identified B7-H4, Spondin 2, and DcR3 as over-expressed genes in ovarian cancer tissues. Sensitive sandwich ELISAs were developed to analyze the level of these novel markers in 68 serum samples from patients with ovarian cancer (16 early stage, 52 late stage) and 108 control samples, and 20 healthy women from which two serum samples were collected 1 year apart. CA125 levels were measured in all samples. RESULTS: Markers were evaluated for their ability to identify clinical disease. The three novel markers and CA125 were elevated in serum of ovarian cancer patients as compared to normal controls. B7-H4 showed the highest specificity, with the lowest frequency of elevation in all control groups. When all cases were compared against all controls, CA125, Spondin 2, B7-H4, and DcR3 showed areas under the ROC curve of 0.87, 0.78, 0.74, and 0.71, respectively. CA125 and B7-H4 showed the best diagnostic performance for early-stage, with AUCs of 0.90 and 0.80, respectively. CONCLUSION: This study demonstrates that B7-H4, Spondin 2, and DcR3 are promising new ovarian cancer markers that may improve early detection of cancer when used in combination with traditional diagnostic tests.