New Blood Test for Ovarian Cancer Shows Promise
Ovarian cancer is often described as a "silent" cancer because it typically
causes no symptoms until it has spread quite extensively. The outlook for women
who have localized ovarian cancer is very good, but only 24 percent of the
cases are detected at this stage. Now, a new test for ovarian cancer may provide
doctors with the ability to detect these cancers much earlier, giving women
with the disease a better chance at successful treatment.The new test measures
the levels of lysophosphatidic acid (LPA) in the blood. Since LPA stimulates
the growth of ovarian cancer cells, researchers speculated its presence in the
blood may provide a good marker for the presence of ovarian cancer."We believe
the most important finding of this study is elevated plasma LPA levels were
detected in patients with early-stage ovarian cancer compared with controls,"
noted the authors in the August 26, 1998 edition of the Journal of the American
Medical Association (JAMA). Finding early-stage cancers would be a great step
forward. The five-year survival rate for women with distant spread of ovarian
cancer is about 25 percent. The outlook for women with localized ovarian
cancer is much better-a 95 percent rate of survival beyond five years.To perform
the study, the researchers enrolled 165 women -- 48 with ovarian cancer, 48
with no cancer, and 69 with other cancers or benign gynecological diseases, and
measured their LPA levels.The researchers found the LPA blood levels of
patients with ovarian cancer were significantly higher than those of the healthy
control group. The LPA levels were elevated in 9 of 10 patients with stage I
ovarian cancer and all patients with stages II, III, and IV ovarian cancers.
However, among the healthy control groups, elevated LPA blood levels were found in 5
of 48 cases. Patients with other gynecological cancers also had higher LPA
levels, as did some participants with benign gynecological diseases, such as
fibroid tumors.Comparison with CA125
The CA125 blood test is currently used to help in diagnosis of ovarian cancer
and in detecting recurrence after treatment. However, CA125 is not always
elevated in patients with early-stage disease and may be elevated in certain
benign conditions, so it is not considered useful as a routine screening test. In
this study, researchers compared CA125 and LPA levels in the patients with
ovarian cancer. They found that LPA levels were more accurate in finding ovarian
cancers than were CA125 levels. For example, 8 of 9 stage I ovarian cancers
had elevated LPA levels; only 2 of these patients had elevated CA125 levels.
Among the 24 patients with stages II, III, and IV ovarian cancer, 100% (24) had
elevated LPA levels compared to 54% (13) with elevated CA125 levels. Of women
with recurrent ovarian cancer, 100% (14/14) had elevated LPA levels, compared
to 86% (12/14) with elevated CA125 levels.Overall 98% (47/48) patients with
ovarian cancer had LPA levels above the cut-off compared to 57% (28/47) who had
elevated CA125 levels.Issues to be addressed
While these early findings are promising, the researchers cautioned that
further studies will be needed to determine the general usefulness of LPA as a
marker for ovarian cancer.The current study examined only a small number of
women; future studies will need to incorporate many more. Additionally, there was a
high rate of false positive tests. Future studies will therefore need to i
dentify which other medical conditions may affect the levels of LPA and devise
strategies will need to be devised for reducing the false positive rate before
this test can be used routinely. Finally, additional studies should be
performed to assess how well LPA levels correlate with stage of disease and disease
status to determine if it is a good marker for monitoring treatment,
progression, and recurrence of disease.
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