Diagnose technieken bij eierstokkanker: Meting LPA (lysophosphatidic acid) in bloed blijkt betrouwbaarder (soms meer dan 40% betrouwbaarder) in vaststellen van beginnende eierstokkanker dan andere diagnoses als CA 125 meting, blijkt uit gerandomiseerde studie. Artikel geplaatst 30 mei 2008
30 mei 2008: bron: uit internationale e-mailgrpoep werd ik hierop gewezen.
Het bloed aanvullend naast de CA 125 testen op LPA = lysophosphatidic acid kan vrouwen eerder duideljkheid geven of zij eierstokkanker hebben of niet. Dit zou een belangrijke vondst kunnen zijn omdat beginnende eierstokanker zelden of nooit wordt herkend omdat vrouwen dan meestal nog nergens last van hebben. Eierstokkanker wordt ook wel de stille moordenaar genoemd omdat het vaak pas geconstateerd wordt als de eierstokkanker al in een gervorderd stadium is. Meestal kan er dan niiet meer curatief behandeld worden. Slechts 25% van vrouwen met utigezaaide eierstokkanker overleven de 5 jaar ondanks de reguliere behandelingen. Vrouwen waar eierstokkanker op tijd bij wordt gevonden en nog niet op afstand is uitgezaaid overleeft 95% de 5 jaar. Een goede diagnosetest kan dus van levensbelang zijn.
In deze studie vergeleken onderzoekers de CA125 test en LPA waarden bij patienten met eierstokkanker. Zij vonden dat LPA waarden accurater waren in het opsproen van eierstokkanker dan de CA125 waarden. Bv., 8 van de 9 stadium I eierstokkanker had verhoogde LPA waarden; slechts 2 van deze patienten had verhoogde CA125 waarden. Onder de 24 patienten met eierstokkanker stadium II, III, en IV had 100% (24) verhoogde LPA waarden vergeleken met 54% (13) met verhoogde CA125 waarden. Van vrouwen met een recidief van eierstokkanker, 100% (14/14) had verhoogde LPA waarden, vergeleken met 86% (12/14) met verhoogde CA125 waarden. Overall 98% (47/48) van de patienten met eierstokkanker had LPA waarden boven het gebruikelijke niveau vergeleken met 57% (28/47) die verhoogde CA125 waarden hadden. De onderzoekers merkten wel op dat er grotere studies nodig zijn omdat er ook relatief veel valse positieve meldingen waren. Dus wel verhoogde LPA waarden maar toch geen eierstokkanker. Maar lijkt me een prima idee om als u twijfelt u gewoon ook op LPA te laten testen. Kost weinig tot niets extra en geeft dus blijkbaar meer zekerheid.
New Blood Test for Ovarian Cancer Shows Promise
Ovarian cancer is often described as a "silent" cancer because it
typically causes no symptoms until it has spread quite extensively. The
outlook for women who have localized ovarian cancer is very good, but
only 24 percent of the cases are detected at this stage. Now, a new
test for ovarian cancer may provide doctors with the ability to detect
these cancers much earlier, giving women with the disease a better
chance at successful treatment.The new test measures the levels of
lysophosphatidic acid (LPA) in the blood. Since LPA stimulates the
growth of ovarian cancer cells, researchers speculated its presence in
the blood may provide a good marker for the presence of ovarian
cancer."We believe the most important finding of this study is elevated
plasma LPA levels were detected in patients with early-stage ovarian
cancer compared with controls," noted the authors in the August 26,
1998 edition of the Journal of the American Medical Association (JAMA).
Finding early-stage cancers would be a great step forward. The
five-year survival rate for women with distant spread of ovarian cancer
is about 25 percent. The outlook for women with localized ovarian
cancer is much better-a 95 percent rate of survival beyond five
years.To perform the study, the researchers enrolled 165 women -- 48
with ovarian cancer, 48 with no cancer, and 69 with other cancers or
benign gynecological diseases, and measured their LPA levels.The
researchers found the LPA blood levels of patients with ovarian cancer
were significantly higher than those of the healthy control group. The
LPA levels were elevated in 9 of 10 patients with stage I ovarian
cancer and all patients with stages II, III, and IV ovarian cancers.
However, among the healthy control groups, elevated LPA blood levels
were found in 5 of 48 cases. Patients with other gynecological cancers
also had higher LPA levels, as did some participants with benign
gynecological diseases, such as fibroid tumors.Comparison with CA125 The
CA125 blood test is currently used to help in diagnosis of ovarian
cancer and in detecting recurrence after treatment. However, CA125 is
not always elevated in patients with early-stage disease and may be
elevated in certain benign conditions, so it is not considered useful
as a routine screening test. In this study, researchers compared CA125
and LPA levels in the patients with ovarian cancer. They found that LPA
levels were more accurate in finding ovarian cancers than were CA125
levels. For example, 8 of 9 stage I ovarian cancers had elevated LPA
levels; only 2 of these patients had elevated CA125 levels. Among the
24 patients with stages II, III, and IV ovarian cancer, 100% (24) had
elevated LPA levels compared to 54% (13) with elevated CA125 levels. Of
women with recurrent ovarian cancer, 100% (14/14) had elevated LPA
levels, compared to 86% (12/14) with elevated CA125 levels.Overall 98%
(47/48) patients with ovarian cancer had LPA levels above the cut-off
compared to 57% (28/47) who had elevated CA125 levels.Issues to be
addressed
> While these early findings are promising, the researchers cautioned that
further studies will be needed to determine the general usefulness of
LPA as a marker for ovarian cancer.The current study examined only a
small number of women; future studies will need to incorporate many
more. Additionally, there was a high rate of false positive tests.
Future studies will therefore need to identify which other medical
conditions may affect the levels of LPA and devise strategies will need
to be devised for reducing the false positive rate before this test can
be used routinely. Finally, additional studies should be performed to
assess how well LPA levels correlate with stage of disease and disease
status to determine if it is a good marker for monitoring treatment,
progression, and recurrence of disease.
