Ovarian cancer is the second leading cause of gynaecologic cancer deaths worldwide, trailing only cervical cancer. It is the most fatal of all gynaecological cancers, with nearly two-thirds of patients diagnosed in the advanced stage. Ovarian cancer has a 5-year overall survival rate of around 48%. The prognosis varies depending on the stage, histologic type, and sensitivity to chemotherapy. It is the leading cause of gynaecologic cancer deaths in most developed countries, with a lifetime risk of 1 in 70.
Cancer antigen 125 (Ca-125) is currently used as an adjunct to ovarian cancer diagnosis, prognosis, and monitoring. Platelet (PLT) count and Ca-125 levels are both prognostic markers in ovarian cancer that are linked to inflammation and immune evasion. To determine the relationship between pre-operative platelet count and serum Ca125 level, and their diagnostic accuracy for the prediction of stage IV epithelial ovarian cancer, a study was carried out by Alegbeleye and John.
The study included forty-two women with histologic diagnosis of epithelial ovarian cancer managed at the University of Port Harcourt Teaching Hospital between January 1, 2016, and December 31, 2020. Following informed consent, a data collection form was used to obtain sociodemographic and clinical characteristics. Pretreatment levels of Cancer Antigen 125 (Ca-125) and Platelets count (PLT) were determined from blood samples.
The sample median platelet count was 308 (307) x 109 /L and median Ca-125 was 286µ/ml (397).
Pre-operative platelets count was significantly associated with Ca-125 (rho= 0.28 p-value = 0.03). Ca-125 had a statistically significant relationship with ovarian cancer histology (X2:19.522; p-value 0.001).
PLTCa-125 (0.51) and PLT only (0.29) had a statistically significant positive correlation with ovarian cancer stage (p 0.001). Since it had an area under the curve (AUC) greater than 0.7, PLT-Ca-125 can be used as a predictive model to correctly stage patients with epithelial ovarian cancer. Ca-125 level (z:-2.24; p-value = 0.025) was significantly associated with thrombocytosis in ovarian cancer patients
Despite new chemotherapeutic, surgical, and other auxiliary treatments, the 5-year survival rate in malignant ovarian tumours remains low. Thus, early detection and treatment are critical for extending the life and improving the quality of life of women with epithelial ovarian cancer. As a result, researchers are constantly looking for new markers for the early detection of malignant ovarian tumours.
In the study, predictive models were developed using ROC curve analysis on PLT alone and PLT-Ca-125 against stage IV ovarian cancer as an outcome. PLT-Ca-125 and tumour stage were found to have a strong positive correlation. This implies that, when compared to both markers alone, PLT-Ca-125 can be used to correctly stratify patients. As a result, it could be a useful marker in predicting advanced-stage disease. Furthermore, because this is a pilot study among women with epithelial ovarian cancer in Nigeria’s southern region, the preliminary data collected will serve as the foundation for a larger future longitudinal study.
Source: Alegbeleye and John / Indian Journal of Obstetrics and Gynecology Research 2024;11(1):17–23; https://doi.org/10.18231/j.ijogr.2024.004
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