Ovarian cancer (OC) is one of the most lethal malignancies in females. A biomarker with high sensitivity and specificity has yet not been discovered which can aid in early diagnosis. Mucin proteins (MUC) proteins have been considered promising diagnostic biomarkers in cancer. We analyzed MUC1 and MUC4 for their diagnostic role in OC.
We analyzed 31 cases of OC and 8 benign ovarian cysts. A pre-therapy whole blood sample was taken and serum levels of MUC1, MUC4 & MUC 16 (CA 125) were evaluated. Cut-off for MUC1 and MUC4 was set using ROC curve analysis at the highest sensitivity and specificity, 141.3ng/mL and 1.206ng/mL respectively. The values were compared with CA125 (established cutoff of 35 U/ml).
Serum level of MUC1 was higher in 33/39 (84.6%) cases (28/31 in malignant cases, 3/8 in benign cases). However, the serum level of MUC4 was lower in 33/39 cases (26/31 in malignant cases, 5/8 in benign cases). CA125 was higher in 33/39 cases (28/31 in malignant cases, 4/8 in benign cases; table). When compared with histological variants of epithelial ovarian cancer, high levels of MUC1 were seen in HGSC, mucinous, endometrioid, and clear cell 16, 4, 3 & 2 respectively (p-value 0.567). For MUC4, a lower value serum level of MUC4 was associated with a diagnostic indicator of ovarian cancer (p= 0.9709). Higher serum level of CA125 was associated with OC (p=0.0025), Type 2 tumor (p= 0.0013), advanced stage (p= 0.0087) and presence of omental metastasis (p= 0.0311). The sensitivity and specificity of CA125 in our study were 90.32% and 62.5% respectively. The sensitivity and specificity of MUC1 in our study were 90.32% and 50% respectively. The sensitivity and specificity of MUC4 in our study were 83.87% and 37.5% respectively.
Serum values in all cases including borderline and benign
No. of cases Mucin 1 Mucin 4 CA125 +VE -VE +VE -VE +VE -VE All cases 39 33 (84.6%) 6 (15.3%) 6 33 33 6 Malignant cases 31 28 3 5 26 28 3 Benign cases 8 2 6 1 7 4 4
The serum level of Mucin 1 was increased in ovarian cancer, while that of MUC4 was decreased in OC. A combined panel of mucin 1, MUC4, and ca125 can aid in a better diagnosis of OC.
AIIMS, New Delhi.
AIIMS, New Delhi.
All authors have declared no conflicts of interest.