Early Detection of Ovarian Cancer-An Enduring Challenge: Pro-Neurotensin and Procalcitonin as Promising Biomarkers

Background: Ovarian cancer is the leading cause of cancer death among female gynecologic malignancies, mainly because most of ovarian cancer diseases are diagnosed at an advanced stage. Hitherto, existing approaches for early detection were not able to reduce mortality. Therefore ongoing research has been focusing on the detection of new biomarkers, which have the potential of being used in screening programs, considering early detection as a premise to affect long-term survival. Methods: 28 ovarian cancer patients and 68 non-cancer control subjects were enrolled into this cross-sectional study. A baseline survey was conducted and participants’ fasting plasma was stored to measure the biomarkers ProNeurotensin (pro-NT), Procalcitonin (PCT) and CA125. Logistic regression was used for uniand multivariate analysis. Results: Ovarian cancer patients showed significant lower concentrations of pro-NT and higher concentrations of PCT and CA 125 in fasting plasma (all p<0.0001). Within the ovarian cancer cases, pro-NT and CA125 respectively emerged to discriminate between early and advanced stage of ovarian cancer (pro-NT: p=0.0117; CA125: p=0.0361), and CA125 was associated with lymph node involvement (p=0.0461). Further analysis illustrated an increase of the predictive value of CA125 by combining pro-NT, PCT and CA125, resulting in a c index of 0.986 compared to the c index for CA125 of 0.950 (p=0.0004 for added value of proNT and PCT on top of CA125). Conclusion: Not-withstanding the potential role as prognostic biomarkers, further studies with larger cohorts is necessary to confirm the findings.