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Xu Y, Shen Z, Wiper DW, et al. Lysophosphatidic Acid as a Potential Biomarker for Ovarian and Other Gynecologic Cancers. JAMA. 1998;280(8):719–723. doi:10.1001/jama.280.8.719
From the Departments of Gynecology and Obstetrics (Drs Xu, Wiper, Kennedy, Belinson, and Casey), Cancer Biology (Drs Xu, Shen, and Casey and Ms Wu), Cell Biology (Dr Morton), and Biostatistics (Dr Elson) and the Cancer Center (Drs Xu, Markman, Casey, and Elson), Cleveland Clinic Foundation, and the Department of Chemistry, Cleveland State University (Dr Shen), Cleveland, Ohio.
Context.— Lysophosphatidic acid (LPA) has been shown to stimulate proliferation
of ovarian cancer cells and is present in the ascitic fluid of patients with
Objectives.— To determine whether elevated levels of LPA are present in plasma from
patients with ovarian cancer and other gynecologic malignancies compared with
healthy controls and to evaluate whether an elevated LPA plasma level may
be a biomarker for these diseases.
Design.— A research assay was used to measure total LPA levels in plasma from
healthy women and women with different diseases. All LPA assays and comparison
of LPA levels and CA125 (an ovarian cancer biomarker) levels were performed
by observers blinded to patient status or group.
Setting.— The Cleveland Clinic Foundation.
Participants.— A convenience sample of 48 healthy control women, 48 women with ovarian
cancer, 36 women with other gynecologic cancers, 17 women with benign gynecologic
diseases, 11 women with breast cancer, and 5 women with leukemias.
Main Outcome Measures.— Total LPA levels in plasma samples from patients and controls.
Results.— Patients in the ovarian cancer group had significantly higher plasma
LPA levels (mean, 8.6 µmol/L; range, 1.0-43.1 µmol/L) compared
with the healthy control group (mean, 0.6 µmol/L; range, <0.1-6.3
µmol/L) (P<.001). Elevated plasma LPA levels
were detected in 9 of 10 patients with stage I ovarian cancer, 24 of 24 patients
with stage II, III, and IV ovarian cancer, and 14 of 14 patients with recurrent
ovarian cancer. Of 36 patients with other gynecologic cancers, 33 also showed
higher LPA levels (mean, 14.9 µmol/L; range, <0.1-63.2 µmol/L),
compared with healthy controls (P<.001). Elevated
plasma LPA levels were detected in 5 of 48 controls and 4 of 17 patients with
benign gynecologic diseases and in no women with breast cancer or leukemia.
In comparison, among a subset of patients with ovarian cancer, 28 of 47 had
elevated CA125 levels, including 2 of 9 patients with stage I disease.
Conclusions.— Plasma LPA levels may represent a potential biomarker for ovarian cancer
and other gynecologic cancers. However, these findings are preliminary and
require confirmation in larger studies.
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