A new blood test for ovarian cancer

Previously, ovarian cancer could only be diagnosed surgically in cases when a woman has a suspicious lesion, which affects more than 200,000 Americans each year.

According to a new study by a medical research team, a novel method can successfully detect stray ovarian cancer tumor markers from a routine blood test and accurately forecast cancer in those who have a lesion or cyst in the pelvic area.

For women without symptoms or a known tumor, there was previously no technology for routine ovarian cancer screening. This new test can rapidly and precisely confirm for doctors that a patient has a malignant ovarian tumor. With the aid of this detection, doctors will be able to categorize which patients need urgent treatment from a gynecological oncologist with specialized training to increase survival.

The study assessed 72 different gene transcripts and seven blood biomarkers associated with ovarian cancer, and it also examined gene expression from isolated cells in blood (including CA125). The study found nine gene transcripts and four biomarkers that may be used to detect cancer from this data. They were applied to create the MAGIC algorithm (Malignancy Assessment using Gene Identification in Captured Cells). The algorithm's performance in identifying ovarian cancer was 95% sensitive and 83% accurate.

In the clinical trial, ovarian cancer in both its early and late stages could be found using MAGIC. Early-stage detection is important for survival but challenging to do. Additionally, additional cancers that originated in or progressed to the pelvic area were detected by the test.

The study included over 180 patients at the University of Rochester Medical Center.

Multiplexed gene expression evaluation of cells captured from blood, with or without serum biomarker levels, accurately detects malignancy in patients with a pelvic mass.

Moore, Richard George MD; Khazan, Negar PhD; Coulter, Madeline Ann MD; Singh, Rakesh PhD; Miller, Michael Craig BS; Sivagnanalingam, Umayal BS, MS; DuBeshter, Brent MD; Angel, Cynthia MD; Liu, Cici MD; Seto, Kelly PhD; Englert, David PhD; Meachem, Philip MS; Kim, Kyu Kwang PhD. Malignancy Assessment Using Gene Identification in Captured Cells Algorithm for the Prediction of Malignancy in Women With a Pelvic Mass. Obstetrics & Gynecology: September 8, 2022 - Volume - Issue - 10.1097/AOG.0000000000004927 doi: 10.1097/AOG.0000000000004927

Knowing how things have been working lately, the test probably picks up genetic markers that do not match the woman's DNA and they probably look for elevated hormone markers in blood that help cells multiply faster

Soo since these things are also elevated with pregnancy, they could possibly get an abortion when they do the chemo treatment. someone can have a small benign tumor that is not cancerous and possibly have elevated levels of things in the blood and if it is just the start of the pregnancy it may pick up similar markers in the blood without even triggering a test to check for pregnancy.

This is my guess of a possible problem which can occur with a test like this.

I have seen too much research that does not have broad enough parameters that cover things properly in my readings. I would guess they would require a pregnancy test before hand, but that would not work always if it is a new pregnancy.

a reply to: rickymouse

I gave you a star for replying, but did you read the entire study? The MAGIC algorithm is composed of the gene expression of PPIA, TBP, TPT1 (transcripts 2 and 3), WFDC-2 (HE4), INHA, VEGFA, CCR2, and SEPT2, plus specific serum levels of β-2-microglobulin (B2M), transferrin, CA 125, and HE4. It will not mistake a pregnancy or a benign tumor as a malignancy. It is very specific to malignancies. I also do not expect this test to be given to every woman or at least not right away. This is a tool that will be used when a gynecological exam shows abnormalities. In the past, a woman would have to be cut open to have her ovaries and uterus examined and biopsied if the gynecological exam showed any abnormalities. This test will save women from having to endure such very invasive surgery that can often cause infertility. 

I sure do wish this had been around a LOT sooner. My wife was diagnosed with stage 4 ovarian cancer back at the end of April..... The only symptoms she had was a nagging cough, that turned out to be fluid around her right lung. She had three masses removed and then been on chemo up to just over a month ago when she had to pause treatment because of side effects. CA125 tumor marker has been dropping rapidly, and a CT scan recently did not show any new developing tumors.

Got my fingers crossed. Oh yeah, I had a heart attack on Memorial Day, so I guess the stress popped a fuse I didn't realize I had.

a reply to: Rich Z

I'm sorry to hear about your wife's cancer and your heart attack. I hope both of you have a good future prognosis.

originally posted by: tamusan
a reply to: rickymouse

I gave you a star for replying, but did you read the entire study? The MAGIC algorithm is composed of the gene expression of PPIA, TBP, TPT1 (transcripts 2 and 3), WFDC-2 (HE4), INHA, VEGFA, CCR2, and SEPT2, plus specific serum levels of β-2-microglobulin (B2M), transferrin, CA 125, and HE4. It will not mistake a pregnancy or a benign tumor as a malignancy. It is very specific to malignancies. I also do not expect this test to be given to every woman or at least not right away. This is a tool that will be used when a gynecological exam shows abnormalities. In the past, a woman would have to be cut open to have her ovaries and uterus examined and biopsied if the gynecological exam showed any abnormalities. This test will save women from having to endure such very invasive surgery that can often cause infertility. 

Sounds like it actually may save unneeded operations then. Expression of epigeneti9c genes can be activated by diet in some cases, I do not know about those particular though, other then VEGFA and SEPT genes. Transferrin can be controlled by diet, that is one of the things that is inversely related to Iron levels in the body I think. I thought that HE4 levels were only risk factors.

Your right, I did not read this article, I read one that did not have all of this listed in it, I saw a summary on it...one paragraph somewhere not long ago and figured it was the same.

I just read this article and it says that the H4 protein being high is a symptom. So would that mean that possible supplementing some iron and a little vitamin C to increase absorption would help deter the cancer? Protein high equals low Iron. Iron actually has a toxic effect on cells if you have too much and since cancer cells are rapidly dividing, they might trigger an accumulation of Iron. Am I thinking right when I am wondering if the extra iron would be bad for the rapidly dividing cancer cells? My question is also whether the HE protein goes high to try to fix the problem by using iron to poison the cell and iron could probably be deficient?

a reply to: rickymouse

Apologies, I didn't see your reply earlier. 

I tried to make this OP basic without getting too much into the scientific stuff. I'm working on writing my medical threads in a way that does not overwhelm the non-scientific among us with a lot of complex scientific jargon. Maybe I swung too far on this one, because I left most of the science out. 

just read this article and it says that the H4 protein being high is a symptom. So would that mean that possible supplementing some iron and a little vitamin C to increase absorption would help deter the cancer? Protein high equals low Iron. Iron actually has a toxic effect on cells if you have too much and since cancer cells are rapidly dividing, they might trigger an accumulation of Iron. Am I thinking right when I am wondering if the extra iron would be bad for the rapidly dividing cancer cells? My question is also whether the HE protein goes high to try to fix the problem by using iron to poison the cell and iron could probably be deficient?

Studies have shown that excessive iron increases cancer incidence and risk, while experimental studies have implicated iron in cancer initiation, tumor growth, and metastasis. Vitamin C, on the other hand, has been shown to help prevent oxidation-induced mutations in human cells. 

I think that having a healthy, well-balanced diet can go a long way towards preventing most forms of cancer and other forms of disease. For ovarian cancer, there are a lot of factors associated with it; genetic mutation, older women are at higher risk, being on hormone therapy for a long time, early start of menstruation, delayed menopause, never getting pregnant, undergoing fertility treatment, being Caucasian, and smoking are the majority of them. 

HE4 is human epididymis protein 4. It is also known as whey acidic protein four-disulfide core domain 2 (WFDC2). It has an important role during innate immune defense and tumorigenesis. It is a protease inhibitor that suppresses the activities of multiple proteases, such as serine proteases and matrix metalloproteinases. Significantly elevated concentrations of HE4 are normally present in the blood of a woman who has ovarian cancer, but it has also been found to be a marker for other diseases. For example, HE4 has been proven to be involved in renal fibrosis. It has also been demonstrated to be a marker of acute and chronic left heart failure and has been proven to be an independent predictor of clinical deterioration in idiopathic pulmonary arterial hypertension (IPAH) patients with right heart failure. It has also been shown that HE4 may play a role in myocardial fibrosis. That is why the MAGIC test uses several markers instead of just one.