Abstract
Introduction: There is a need to improve the diagnosis and prognosis of ovarian carcinoma, particularly the serous type. Mesothelin and HE4 are two new biomarkers that are expressed in serous ovarian carcinoma and can be measured in serum and other body fluids, including urine, by using ELISA. The measurement of antibodies to these markers can provide extra useful information.
Areas covered: A literature search was performed up to 1 December 2010, using the Internet (e.g., PubMed), on articles concerning mesothelin and HE4 for the diagnosis of ovarian carcinoma. The authors also include up-to-date recent information from the research performed in their own laboratories.
Expert opinion: The combination of CA125 with HE4 facilitates the triaging of women with a pelvic mass and detects more stage I/II tumors than CA125, the present ‘gold standard’, when used alone. Assaying urine for HE4 or mesothelin may detect early ovarian carcinoma more often than assaying serum. Antibodies to mesothelin and HE4 are more frequent in women with ovarian carcinoma or with certain types of infertility than in controls. No available biomarker or multimarker panel lends itself to screening large populations of symptomless women to make possible detection of high-grade serous ovarian carcinoma at stage I or stage II. The authors anticipate that, within the next 5 years, a greater emphasis will be given to the fact that the different subtypes of ovarian carcinoma represent different types of disease. Each different type of disease will require a different diagnostic approach and more efforts will focus on high-grade serous ovarian carcinoma for which the clinical need is the greatest.
Acknowledgments
In addition to various collaborators on their published studies, the authors acknowledge interactions and collaborations with P Liu, J Jaffar, YY Yip, O Nilsson, N Sardesai, T Verch, N Kiviat, E Swisher and N Urban.
Notes
This box summarizes key points contained in the article.