The predictive role of estrogen, FSH, and LH in combination with biomarkers for early ovarian cancer detection

Background. The early detection of ovarian cancer is not easy, and the predictive value of hormonal (estrogen, follicle-stimulating hormone (FSH), luteinizing hormone (LH)) and molecular biomarkers can be used to facilitate the diagnosis and patient outcome. The purpose of the study was to evaluate the predictive capacity of estrogen, FSH, and LH together with some biomarkers in the early diagnosis of ovarian cancer. Materials and methods. This was a case-control study involving 120 women who have just been diagnosed with ovarian cancer, and 60 healthy women. Clinical, radiological and histopathological diagnosis was done. Others excluded were those whose malignancies, autoimmune, hepatic or renal conditions had been previously treated, pregnant, or declined. The blood samples were fasted, and serum was separated and frozen at –80 °C. Strict quality controls were observed in measuring the levels of estrogen, FSH, LH, tumor markers CA-125, HE4, AFP, and CEA by ELISA or automated assays. Results. Ovarian cancer patients were marginally older and fatter compared to the controls, more postmenopausal and with cancer family history. The levels of estrogens were considerably low with an increase in FSH and LH, which indicated a disruption in hormones. CA-125, HE4, AFP and CEA tumor markers were significantly increased, estrogens were inversely correlated, FSH and LH had positive relationships. Logistic regression proved that CA-125 and HE4 are robust predictors. Hormones in combination with tumor markers had the best diagnostic accuracy (AUC 0.94, sensitivity 91.6 %, specificity 90 %). Conclusions. Low estrogen, high FSH and LH, and high levels of CA-125 and HE4 are all related to early-stage ovarian cancer. Hormonal and tumor markers should be combined to enhance the accuracy of diagnosing this condition, which is characterized by hormonal malfunctioning and unnatural cell life, which may be considered an indisputable method of diagnosing the disease in its early stages.