Role of Thrombopoietin in the Diagnosis of Ovarian Cancer: A Brief Review XE01-XE03
Dr. Amar Ranjan,
Room No-422, IRCH, All India Institute of Medical Sciences, New Delhi-110029, Delhi, India.
Ovarian Cancer (OC) is the most fatal condition among all gynaecologic malignancies. The survival rate of early and advance stage of OC is 80-90% and 15-20% respectively. This data constitutes the need of a novel biomarker for early diagnosis, which may distinguish malignant tumours from benign ovarian cysts. Presently in practice there are three screening techniques: bimanual pelvic examination, serum Cancer Antigen (CA) 125 and transvaginal ultrasound. Bimanual pelvic examination can detect only 1 in 10,000 ovarian cancers in women presenting to the clinic. CA 125 is raised in 80% of cases of ovarian carcinoma; however, if the carcinoma is limited to ovary, the raised value is seen only in 50% of women. It is mainly useful in postmenopausal women. Ultrasonography also lacks specificity and sensitivity, apart from being costly as a screening test. Studies are going on for search of a biomarker, which may complement CA 125. Most common among these are Human Epididymis Protein 4 (HE4), Thrombopoietin (TPO), CA19-9, human kallikrein 10, human kallikrein 6, osteopontin, claudin 3, DF3 (murine monoclonal antibody), vascular endothelial growth factor, MUC1, mesothelin etc. In 2008, FDA approved the use of HE4 assay for monitoring of progressive disease in patients with epithelial ovarian cancer. Similarly TPO also holds the promise of being a biomarker to complement CA125 and many studies are indeed available to support the association of TPO and OC. In this review article we have summarised and analysed such studies.