New biomarker HE4 helps early diagnosis of ovarian cancer
Release date: 2016-06-16 Source: Chinese Journal of Science Nucleic Acid Extraction System Nucleic Acid Extraction Kit,Nucleic Acid Purification Kit,Nucleic Acid Extraction System,Nucleic Acid Extraction Instrument HANGZHOU DIAN BIOTECHNOLOGY CO., LTD. , https://www.dianbiotech.com
A better diagnostic tool is urgently needed for the clinical diagnosis of ovarian cancer.
In the past 10 years, the incidence of ovarian cancer in China has increased by 30% and the mortality rate has increased by 18%. Because early symptoms are not obvious, and early tumors are difficult to detect in pelvic examination, 70% to 75% of ovarian cancer patients are advanced at the time of diagnosis. Ovarian cancer is therefore called "silent killer."
More unfortunately, in the past 30 years, the 5-year survival rate of patients with ovarian cancer has not improved significantly. On June 2nd, a conference held in Shanghai with the theme of “Focus on HE4 detection and away from ovarian cancerâ€, Wu Xiaohua, director of gynecology at Fudan University Cancer Hospital, pointed out that if breast cancer can be detected early, the survival rate of patients can be from 19 %~23% is increased to 71%~90%, and it is very likely to cure.
The discovery and application of human epididymis protein 4 (HE4), a novel biomarker of ovarian cancer, is a more powerful basis for early diagnosis and treatment of ovarian cancer while making up for the lack of existing detection methods.
CA125 - imperfect "gold standard"
Although the incidence of ovarian cancer is increasing year by year, the cause is still unclear.
The five high-risk groups of ovarian cancer previously released by the Centers for Disease Control and Prevention (CDC) are: women over the age of 50; those who have no birth or infertility, have a history of endometriosis; more than 10 estrogens alone Years; people with mutations in breast cancer susceptibility genes (BRCA1 or BRCA2) and those with a history of ovarian tumors or malignant tumors.
Wu Xiaohua said that although the cause of ovarian cancer is not completely clear at present, according to epidemiological investigations, the occurrence of ovarian cancer has a great relationship with women's fertility. More and more women in first-tier cities choose “Dinkâ€, and non-fertility may bring hidden dangers to women’s health.
Not only that, Guo Lin, director of the Department of Clinical Laboratory of Fudan University Cancer Hospital, pointed out that erotic supplementation of estrogen, such as eating ferrets, royal jelly, some beauty oral liquids, etc., as well as the "ovarian maintenance" project of the beauty salon, also have May increase the risk of ovarian cancer.
However, ovarian cancer is the most common malignant tumor of female reproductive organs, and it is the first cause of death in gynecological malignant tumors in China. Because the ovary is located deep in the pelvic cavity, early clinical symptoms are not obvious, and pelvic examination is difficult to detect before there is no compression symptoms, so 80 % of patients were found to be advanced and had spread to other organs, missing the best treatment opportunity.
"The early clinical symptoms of ovarian cancer are not obvious, lack specificity, and often confused with common diseases caused by other causes such as the digestive tract. The use of scientific and accurate detection methods is the key to early detection of ovarian cancer." Wu Xiaohua said.
However, existing diagnostic testing methods still face the challenge of accuracy. At present, the diagnosis of ovarian cancer is mainly based on vaginal ultrasonography (TVU) and blood test for carbohydrate antigen 125 (CA125), but both of these methods have their own limitations. TVU's benign and malignant interpretation of the mass depends on the doctor's clinical experience, resulting in a high proportion of false positives. The current CA125, which is commonly known as the "gold standard", is not perfect in actual diagnosis.
Experts say that the specificity of CA125 is low, and it is also elevated in many gynecological benign diseases and other systemic malignant diseases. In addition, the sensitivity of CA125 is also relatively low, about 20% to 30% of epithelial ovarian cancer is not expressed, about 50% of early ovarian cancer patients did not appear elevated CA125 levels, and in endometriosis CA125 is also elevated in benign diseases such as erythematosus and ovarian cysts, which are prone to false positives or false negatives.
Thus, in the clinical diagnosis of ovarian cancer, a better diagnostic tool is urgently needed to diagnose ovarian cancer as early as possible. Under this circumstance, the discovery and application of the novel biomarker human epididymis protein 4 (HE4) can make up for the lack of existing detection methods, and also provide a more powerful basis for early diagnosis and treatment of ovarian cancer.
New biomarkers improve diagnostic accuracy
"Normally, HE4 has a very low level of expression in humans, but it is very high in tissues and serum of patients with ovarian cancer. As a single tumor marker, HE4 has the highest sensitivity for ovarian cancer detection, especially in the early stage. In stage I disease in the asymptomatic phase," Guo Lin said.
Guo Lin said that HE4 has four main characteristics: first, it is expressed in the reproductive system and respiratory system; second, it is the most common elevated marker of ovarian cancer; third, regardless of the early or late stage of the disease, Increased expression of mRNA and protein levels occurs; fourth, an effective complement to CA125.
As a new tumor marker, it can help early diagnosis, differential diagnosis, treatment monitoring and prognosis evaluation of ovarian cancer by detecting the level of HE4 in the body and its changes. Under normal physiological conditions, HE4 has a very low level of expression in humans, but is highly expressed in ovarian cancer tissues and patient serum.
In addition, in order to be able to accurately diagnose patients as early as possible, the most comprehensive diagnostic method for ovarian cancer is to use HE4 combined with CA125.
Studies have shown that the sensitivity of using HE4 alone is about 82.7%, and the sensitivity of using CA125 alone is 45.9%. At the same time, the detection of two biomarkers has higher sensitivity and highest specificity, and the negative predictive value and diagnostic accuracy of ovarian cancer are increased to 96.2% and 90.7%, respectively.
"HE4 combined with CA125 detection can effectively differentiate the benign ovarian masses, cysts and ovarian cancer, and guide doctors to develop personalized treatment plans for patients." Guo Lin said that 88% of patients with ovarian cancer will have HE4, clinicians can The ROMA index was calculated by HE4 in combination with CA125 to assess the risk of epithelial ovarian cancer in female pelvic masses.
ROMA is a ovarian malignant tumor risk calculation method established by using the detection values ​​of CA125 and HE4. In recent years, foreign studies have shown that ROMA can effectively evaluate the risk of epithelial ovarian cancer in premenopausal and postmenopausal women with pelvic masses, and better identify them. Benign and malignant ovarian tumors.
Guo Lin said that combined with a single marker, HE4 and CA125 combined detection can more accurately detect malignant tumors, and can reduce false negative results by 30% to 50%, greatly increasing the accuracy of ovarian cancer diagnosis. Early identification of stage I/II ovarian cancer and reduction of missed diagnosis due to negative test alone is a highly sensitive marker for early diagnosis of ovarian cancer.
"In the face of severe tumor prevention and treatment, the important medical value of tumor markers in tumor-assisted diagnosis and treatment monitoring and follow-up has been more and more recognized." Chen Jintian, director of professional diagnosis department of Roche Diagnostics, also said that Roche diagnosis always pays attention to The field of tumor marker detection provides a complete test menu for cancer patients. The Roche Diagnostics Elecsys HE4 test combined with the Elecsys CA125 test requires only one tube of blood to provide clinicians with more accurate results in 18 minutes, helping to improve the early diagnosis and clinical management of ovarian cancer.
Extended reading
Precancerous diagnosis research highlights
Mysterious MicroDNAs help detect cancer.
The strange circular DNA that exists outside the chromosome is not the same as the cell type that produces the DNA incorrectly. These circular DNAs can be used as indicators to detect different types of cancer. MicroDNAs are such strange circular DNAs that are germline specific. Different cell types, such as prostate cancer cells or ovarian cancer cells, produce specific types of MicroDNAs, which allows MicroDNAs to serve as potential biomarkers to reveal the biological processes of disease development. Related research has been published in the international magazine Cell Reports.
Diagnosis of cancer using DNA profiling.
Lu Yuming, a professor at the Chinese University of Hong Kong, has found that there is "drifting" fetal DNA in the peripheral blood of pregnant women. That is to say, assuming that each milliliter of mother sample is equivalent to 1000 genomes, it contains a total of 1900 mothers with chromosome 21 and 100 euploids. The 21st chromosome of the fetus or the chromosome 21 of the 150 21 trisomy. If the diagnosing doctor finds a difference in 50 chromosomes in the DNA sample, he needs to count hundreds of thousands of molecules to improve the discriminating ability. The results of this research have been published in the PNAS magazine.
Use diamonds to track early cancer.
Although in the mass culture, small diamonds are just a small piece of compressed carbon black that nobody cares about, physicists at the University of Sydney have developed a way to use diamonds to identify cancer cells before they become life threatening. Their findings reveal how the nanoscale synthetic version of this gemstone can illuminate early cancers in non-toxic, non-invasive, magnetic field-enhanced magnetic resonance imaging (MRI).
British scientists have found typical variant genes.
People can't predict life, but maybe in the near future, we can know when we will get cancer. The director of the Sanger Institute in the United Kingdom and geneticist Michael Stratton reported in Nature Genetics that he and his colleagues studied DNA sequences in 10,000 cancer patients in an attempt to find representative genetic variants. . If a person's genetic mutation is faster than the average person, it means he is more likely to have cancer. This discovery may help doctors “predict†cancer and help the medical team tailor treatments for patients. (summer finishing)