Abstract
BACKGROUND: Ovarian cancer (OC) is the most lethal gynecological cancer among females, and its early diagnosis could help for better outcomes of the patients. AIM: To investigate the utility of serum insulin-like growth factors-binding proteins 2 (IGFBP2), secreted phosphoprotein 1 (SPP1), thrombospondin 1 protein (TSP1) and D-dimer levels in addition to currently used biomarkers [cancer antigen 125 (CA125) and human epididymis protein 4 (HE4)] in the diagnosis of epithelial OC (EOC). METHODS: This is a case-control study that included fifty females diagnosed with EOC, 10 females with benign ovarian masses recruited from the Egyptian National Cancer Institute, and 30 healthy females as a control group. All subjects were assessed for serum HE4, CA125, IGFBP2, TSP1 and SPP1 measurement by enzyme-linkedimmunosorbent assay. RESULTS: There was a statistically significant difference in serum levels between EOC, benign ovarian masses, and healthy control groups regarding CA125 and SPP1 (P < 0.001 for both markers), while HE4 and IGFBP2 increased significantly in EOC compared to healthy control groups (P < 0.001 for all markers) with no significant difference between EOC and benign ovarian masses groups. However, there was no statistically significant difference among EOC, benign ovarian masses, and healthy control groups regarding the TSP1 serum levels (P = 0.051). Receiver operating characteristic analysis revealed that combined assessment of SPP1 with CA125 or TSP1 increased the diagnosis of EOC patients to a sensitivity, specificity, and area under curve of (93.3%, 100%, 0.968; respectively, P < 0.001). CONCLUSION: SPP1 may be a potential marker for the differentiation between benign and malignant ovarian masses, while IGFBP2 can differentiate between healthy females and females with ovarian masses. Combining SPP1 with CA125 or TSP1 provides high sensitivity and specificity for the detection of EOC patients.