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Prognostische und prädiktive Marker des Ovarialkarzinoms

Prognostic and predictive markers of ovarian cancer

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Bedingt durch die häufige Resistenz gegen platinhaltige Chemotherapeutika und das Fehlen einer geeigneten Methode zur Früherkennung hat das Ovarialkarzinom die ungünstigste Prognose aller gynäkologischen Malignome. Um die Mortalität zu senken, gilt es, neuartige molekulare Therapien zur Überwindung von Platinresistenz zu entwickeln. Gleichzeitig müsste eine geeignete Methode zur Früherkennung etabliert werden, die wegen der geringen Inzidenz des Ovarialkarzinoms eine Spezifität von über 99% und einen positiven prädiktiven Wert von mindestens 10% aufweisen muss. Da bildgebende Verfahren sich als ungeeignet erwiesen haben, könnten neue Biomarker – etwa in Ergänzung zum etablierten Tumormarker CA-125 – als Früherkennungsmarker dienen. Eine weitere wichtige Rolle könnten sie auch bei der Diskriminierung zwischen einem benignen und einem malignen Befund spielen, wenn ein Ovarialtumor bereits diagnostiziert wurde. Schließlich dienen Biomarker als Indikatoren für die Prognose oder das Ansprechen einer Therapie. Der Fokus des Beitrags richtet sich auf Biomarker zur Risikoabschätzung im Rahmen von bereits etablierten Testverfahren und zur Früherkennung.

Abstract

Ovarian cancer has the worst prognosis among all gynecological cancers mainly due to resistance to platinum-containing therapeutics and the lack of an effective screening method for the detection of early stage disease. In order to reduce the mortality of ovarian cancer it will be necessary to overcome the chemoresistance with novel targeted therapies and to develop an early detection test. As ovarian cancer has a low incidence any screening method has to exhibit a specificity of 99 % and a positive predictive value of 10 %. Imaging techniques, including transvaginal ultrasound evaluation have not achieved this aim and, therefore, novel biomarkers in addition to the well established tumor marker CA-125 may serve as early detection markers. In addition, serum biomarkers could help to preoperatively discriminate between benign and malignant ovarian tumors and novel biomarkers may serve as prognosticators of the disease. Molecular screening methods with biostatistical evaluation have identified many novel biomarkers. Several marker panels have been evaluated so far and others are under investigation. This review focuses on clinical trials investigating the value of biomarkers (a) to discriminate between benign and malignant ovarian tumors and (b) for early detection of ovarian cancer.

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Authors and Affiliations

  1. Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Aachen, RWTH, Pauwelsstr. 30, 52074, Aachen, Deutschland

    I. Meinhold-Heerlein, K. Bräutigam, U. Pecks, N. Maass & D.O. Bauerschlag

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  1. I. Meinhold-Heerlein
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  2. K. Bräutigam
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  3. U. Pecks
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  4. N. Maass
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  5. D.O. Bauerschlag
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Correspondence to I. Meinhold-Heerlein.

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Meinhold-Heerlein, I., Bräutigam, K., Pecks, U. et al. Prognostische und prädiktive Marker des Ovarialkarzinoms. Gynäkologe 46, 386–391 (2013). https://doi.org/10.1007/s00129-012-3129-z

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  • DOI: https://doi.org/10.1007/s00129-012-3129-z

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