Of the cases included

in this study, 76% (i.e. 35 cases) were early stage disease (i.e. Stages I and II). The median CA125 plasma concentrations were 13 U/ml (range 3 – 84) for controls and 502 U/ml (5 – 10,209) for cases. In 3 controls, CA125 GSK2126458 nmr concentration was ≥ 35 U/ml. In 6 cases, CA125 concentration was < 35 U/ml. At a threshold of 35 U/ml, the sensitivity and specificity of CA125 were 87.0 and 95.1%, respectively. Variation with Disease State, Stage and Tumor Type The variation in plasma analyte concentrations for control and case cohorts is presented in Figure 1. Median plasma concentrations of immunoreactive selleckchem MDK, AGR2 and CA125 were significantly greater in the case cohort (909 pg/ml, 765 pg/ml and 502 U/ml, respectively n = 46) than in the control (383 pg/ml, 188 pg/ml selleck and 13 U/ml, respectively n = 61)

cohort (p < 0.001, as assessed by Mann Whitney tests). Within control or case cohorts, plasma concentrations of AGR2 displayed no significant correlations with either CA125 or midkine concentrations (as assessed by Spearman's correlation, p > 0.05). Within the case cohort, MDK plasma concentrations significantly correlated with CA125 concentrations (ρ = 0.383, p < 0.01). Data were further analysed with respect to tumor type and Stage (Table 3). No statistically significant effects of either tumor type or stage on biomarker plasma concentrations were identified (Kruskal-Wallis one-way analysis of variance, p > 0.05). Figure 1 Plasma biomarker concentrations. The median plasma concentration within each group (normal women (controls) n = 61 and women with ovarian cancer (cases) n = 46) is represented by the horizontal line. Biomarker concentrations were

significantly greater in case cohorts (solid symbols) when compared to their respective control cohort (open symbols) (p < 0.001, Mann Whitney tests). Data are presented as log (plasma concentration). CA125 as U/ml; and MDK and AGR2 as pg/ml. Table 3 Case cohort variation in plasma analyte concentration by stage of disease and tumor type, as assessed by Kruskal-Wallis One Bumetanide Way Analysis of Variance (Stage and Tumor Type). Analyte Stage n = 45# (p) Tumor Type n = 43† (p) MDK 0.722 0.839 AGR2 0.776 0.334 CA125 0.524 0.214 # 1 sample was unstaged † 3 samples were not typed Receiver Operator Characteristic Curve Analysis and Multi-analyte Modelling ROC curves were generated for each individual analyte. The area under the curve (AUC) for MDK, AGR2 and CA125 was: 0.753 ± 0.049; 0.768 ± 0.048; 0.934 ± 0.027, respectively (AUC ± SEM). There was no significant difference between the AUC for midkine and AGR2. The AUC for CA125 was significantly greater than that for both midkine and AGR2 (p < 0.001, Table 4). Table 4 Comparison of AUC for MDK, AGR2, CA125 and multi-analyte panel Data represent AUC ± standard errors (SEM). Analyte AUC ± SEM p CA125 0.934 ± 0.027   MDK 0.753 ± 0.049 < 0.001 AGR2 0.768 ± 0.048 = 0.001 Multi-analyte Algorithm 0.988 ± 0.011 = 0.