@article{3086193,
    title = "Ovarian cancer early detection by circulating CA125 in the context of anti-CA125 autoantibody levels: Results from the EPIC cohort",
    author = "Fortner, R.T. and Schock, H. and Le Cornet, C. and Hüsing, A. and Vitonis, A.F. and Johnson, T.S. and Fichorova, R.N. and Fashemi, T. and Yamamoto, H.S. and Tjønneland, A. and Hansen, L. and Overvad, K. and Boutron-Ruault, M.-C. and Kvaskoff, M. and Severi, G. and Boeing, H. and Trichopoulou, A. and Papatesta, E.-M. and La Vecchia, C. and Palli, D. and Sieri, S. and Tumino, R. and Sacerdote, C. and Mattiello, A. and Onland-Moret, N.C. and Peeters, P.H. and Bueno-de-Mesquita, H.B. and Weiderpass, E. and Quirós, J.R. and Duell, E.J. and Sánchez, M.-J. and Navarro, C. and Ardanaz, E. and Larrañaga, N. and Nodin, B. and Jirström, K. and Idahl, A. and Lundin, E. and Khaw, K.-T. and Travis, R.C. and Gunter, M. and Johansson, M. and Dossus, L. and Merritt, M.A. and Riboli, E. and Terry, K.L. and Cramer, D.W. and Kaaks, R.",
    journal = "International Journal  of Cancer",
    year = "2018",
    volume = "142",
    number = "7",
    pages = "1355-1360",
    publisher = "Wiley-Liss, Inc.",
    issn = "0020-7136",
    doi = "10.1002/ijc.31164",
    keywords = "autoantibody;  CA 125 antigen;  CA125 autoantibody;  unclassified drug;  autoantibody;  CA 125 antigen;  membrane protein;  MUC16 protein, human;  tumor marker, adult;  aged;  area under the curve;  Article;  blood sampling;  cancer growth;  case control study;  cohort analysis;  controlled study;  correlational study;  early cancer diagnosis;  electrochemiluminescence;  female;  human;  immune response;  major clinical study;  ovary cancer;  priority journal;  blood;  early cancer diagnosis;  immunology;  middle aged;  ovary tumor;  procedures;  receiver operating characteristic;  sensitivity and specificity, Adult;  Aged;  Area Under Curve;  Autoantibodies;  Biomarkers, Tumor;  CA-125 Antigen;  Case-Control Studies;  Cohort Studies;  Early Detection of Cancer;  Female;  Humans;  Membrane Proteins;  Middle Aged;  Ovarian Neoplasms;  ROC Curve;  Sensitivity and Specificity",
    abstract = "CA125 is the best ovarian cancer early detection marker to date; however, sensitivity is limited and complementary markers are required to improve discrimination between ovarian cancer cases and non-cases. Anti-CA125 autoantibodies are observed in circulation. Our objective was to evaluate whether these antibodies (1) can serve as early detection markers, providing evidence of an immune response to a developing tumor, and (2) modify the discriminatory capacity of CA125 by either masking CA125 levels (resulting in lower discrimination) or acting synergistically to improve discrimination between cases and non-cases. We investigated these objectives using a nested case–control study within the European Prospective Investigation into Cancer and Nutrition cohort (EPIC) including 250 cases diagnosed within 4 years of blood collection and up to four matched controls. Circulating CA125 antigen and antibody levels were quantified using an electrochemiluminescence assay. Adjusted areas under the curve (aAUCs) by 2-year lag-time intervals were calculated using conditional logistic regression calibrated toward the absolute risk estimates from a pre-existing epidemiological risk model as an offset-variable. Anti-CA125 levels alone did not discriminate cases from controls. For cases diagnosed <2 years after blood collection, discrimination by CA125 antigen was suggestively higher with higher anti-CA125 levels (aAUC, highest antibody tertile: 0.84 [0.76–0.92]; lowest tertile: 0.76 [0.67–0.86]; phet = 0.06). We provide the first evidence of potentially synergistic discrimination effects of CA125 and anti-CA125 antibodies in ovarian early detection. If these findings are replicated, evaluating CA125 in the context of its antibody may improve ovarian cancer early detection. © 2017 UICC"
}