Measuring the levels of a specific protein found in a patient’s blood or biopsy sample might help determine the diagnosis and prognosis of ovarian cysts (growths), according to a recent study published in the journal Cancer. These results appear to be valuable in determining whether a cyst is cancerous or benign (non-cancerous) and/or defining the specific pathology (cell type) of ovarian cancer upon diagnosis.
Ovarian cancer is a common malignancy, with about 25,000 new cases diagnosed in the United States each year. The ovary makes female hormones and stores all of the eggs that are released once a month during ovulation. There are two ovaries, one on each side of the uterus. The earlier ovarian cancer is detected, the higher the cure rate. Unfortunately, because ovarian cancer begins deep in the pelvis and often does not cause any symptoms until it has reached advanced stages, the disease often goes unnoticed until it has reached a stage where it is incurable. Therefore, researchers have been investigating novel approaches to detect ovarian cancer as early as possible.
Cancer cells need nutrients to spread and grow throughout the body. They get these nutrients from circulating blood in the body. The formation of new blood vessels (angiogenesis) is a crucial component for the growth of cancer. The new blood vessels enable blood to reach growing cancer cells to supply needed nutrients.
Vascular endothelial growth factor (VEGF) is a specialized type of protein that facilitates the process of angiogenesis. High levels of VEGF are expressed in a variety of cancers and have been implicated in the development of ovarian cancer. However, the few clinical trials evaluating this correlation have been too small to warrant any definitive conclusions(
Researchers from the Netherlands recently conducted a clinical trial further evaluating the association between high levels of expressed VEGF and ovarian cancer. In this trial, 107 women had ovarian cysts and were scheduled to have them surgically removed. Prior to surgery, all women had a blood sample taken from a vein in their arm to test for VEGF levels. All of the removed cysts were also tested for VEGF levels.
The average VEGF levels found in the fluid of cancerous cysts were approximately 20 times higher than levels found in non-cancerous cysts. Levels of VEGF varied significantly with differing pathology in patients with ovarian cancer. Importantly, the average VEGF levels found in pre-operative blood samples were nearly 3 times as high in patients with ovarian cancer compared with patients whose cysts were benign.
These results indicate a direct association between elevated levels of VEGF in a patient’s blood and/or fluid from an ovarian cyst with the presence of ovarian cancer. Moreover, VEGF levels also appear to be linked to specific pathological types of ovarian cancer. These implications will need to be further explored in future clinical trials in order to define their role in the diagnosis and prognosis of ovarian cancer.
Women with ovarian cysts who are required to undergo future diagnostic testing may wish to speak with their physician about the risks and benefits of participating in a clinical trial further evaluating the significance of VEGF levels. (
Cancer, Vol 91, No 2, pp371-377, 2001)
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