The utility of serum N-ERC/mesothelin as a biomarker of ovarian carcinoma

Our plain-English summary of The utility of serum N-ERC/mesothelin as a biomarker of ovarian carcinoma, by H. Saeki, A. Hashizume, H. Izumi, et al (Oncology Letters, 2012).

The study

• Authors: H. Saeki, A. Hashizume, H. Izumi, F. Suzuki, K. Ishi, M. Nojima, M. Maeda, O. Hino
• Journal: Oncology Letters
• Published: 2012;4(4):637-641
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Ovarian carcinoma has been difficult to diagnose at an early stage. Recently, it has been recognized that the measurement of blood N-ERC/mesothelin levels aids early detection in and postoperative therapeutic monitoring of patients with mesothelioma, who have been exposed to asbestos. ERC/mesothelin has also been reported to be expressed in ovarian carcinoma. We determined serum N-ERC/mesothelin levels in patients with ovarian carcinoma using an enzyme-linked immunosorbent assay (ELISA). In addition, we immunohistochemically evaluated surgically resected specimens for C-ERC/mesothelin expression. As a result, of the 32 patients with ovarian tumors (18 carcinoma, 2 borderline tumors), one patient with serous adenocarcinoma showed increased N-ERC/ mesothelin levels. Immunohistochemically, of the 20 ovarian tumor (carcinoma and borderline tumor) specimens evaluated for serum N-ERC/mesothelin, 9 (45.0%) were positive for C-ERC/mesothelin. The C-ERC/mesothelin-positive specimens were found to be serous and clear cell adenocarcinomas. If serum N-ERC/mesothelin, which is considered useful for early detection in and therapeutic monitoring of patients with mesothelioma, may also be used for ovarian carcinoma monitoring, it may be a valuable serum tumor marker for the early detection of ovarian carcinoma.

In plain English

This study from Juntendo University in Japan tested whether a blood marker called N-ERC/mesothelin, used in monitoring mesothelioma, might also mark ovarian carcinoma. It did not study asbestos exposure. The authors measured the marker in blood serum from 32 patients with ovarian tumors, 20 of whom had ovarian carcinoma or borderline tumors. They also stained tumor tissue for a related protein, C-ERC/mesothelin. Using cut-off values previously reported for mesothelioma, the authors reported raised blood levels in one of the 20 patients, who had serous adenocarcinoma. In tissue, 9 of the 20 carcinoma and borderline specimens were positive. Positive carcinomas were serous (5 of 7) or clear cell (3 of 6) adenocarcinomas. In the one patient with raised levels, the marker fell after surgery and chemotherapy and rose again when the cancer returned. The authors concluded that the marker may be a valuable serum tumor marker for early detection of ovarian carcinoma if it can also be used for monitoring. They noted that the mesothelioma cut-off may not be valid for ovarian carcinoma and that larger studies are needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Laboratory study of blood serum (ELISA) and surgical tissue (immunohistochemistry) from patients with ovarian tumors, with a detailed description of one patient's course
• Who was studied: 32 patients with ovarian tumors at Juntendo University Urayasu Hospital, Japan: 18 carcinoma, 2 borderline tumors, 4 Krukenberg tumors, 3 sex-cord stromal tumors and 5 benign tumors. The article prints a median age of 51.2 years (range 20-75). Of the 20 carcinoma and borderline patients, 8 were at stage I, 1 at stage II and 11 at stage III or IV. Study dates are not given.
• Exposure: No asbestos exposure was studied. Asbestos is mentioned only in the background, describing mesothelioma patients. The study measured a blood and tissue marker (ERC/mesothelin) in ovarian tumor patients.
• Main results:
  • Using mesothelioma cut-offs reported earlier (2.78 ng/ml for N(7-4) and 5.6 ng/ml for N(7-16)), one of the 20 carcinoma and borderline patients, in the group sampled before surgery, showed increased serum N-ERC/mesothelin. This patient had serous adenocarcinoma, with N(7-4) = 4.76 ng/ml and N(7-16) = 18.67 ng/ml.
  • In tissue staining, 9 of the 20 carcinoma and borderline specimens (45.0%) were positive for C-ERC/mesothelin and 11 (55.0%) were negative. Among the 18 carcinoma specimens, 8 (44.4%) were positive.
  • By tumor type, 5 of 7 serous adenocarcinomas (71.4%) and 3 of 6 clear cell adenocarcinomas (50.0%) were C-ERC/mesothelin positive. The 1 mucinous and 4 endometrioid adenocarcinomas were negative.
  • In the one patient with raised levels, after surgery and chemotherapy the tumor disappeared on imaging and serum levels fell (N(7-4) = 2.00 ng/ml, N(7-16) = 2.50 ng/ml, CA125 = 5.2 U/ml).
  • In the same patient, 6 months after chemotherapy, levels rose (N(7-4) = 3.33 ng/ml, N(7-16) = 9.95 ng/ml, CA125 = 108.5 U/ml) and a recurrence was found. After 4 further cycles of chemotherapy, levels rose again (N(7-4) = 5.00 ng/ml, N(7-16) = 26.80 ng/ml, CA125 = 303.7 U/ml) with an enlarged tumor. The authors described these results as consistent with the clinical course.
• The authors' conclusion: The authors concluded that if serum N-ERC/mesothelin can also be used for monitoring ovarian carcinoma, it may be a valuable serum tumor marker for its early detection.
• Limitations the authors state:
  • The cut-off value came from healthy people and mesothelioma patients, and the authors state that its validity for ovarian carcinoma is not certain.
  • The authors state that studies with larger sample sizes are required.
  • Tumors were counted as positive only if at least 30% of tumor cells stained, so some negative tumors could have weak or partial expression.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelin, Biomarker, Carcinoma, Mesothelioma, Adenocarcinoma, Tumor Marker.

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