Aminoterminal propeptide of procollagen III in benign gynecologic conditions and ovarian cancer

The objective of this work was to judge the usefulness of preoperative measurement of the amino-terminal propeptide of type III procollagen [PIIINP] as a tumor marker. Seventy patients with mean age 40 +/- 8 years and 15 healthy ovulating women with mean age 25 +/- 5 years, served as a control group, were included in this study. The patients group was classified into four subgroups: Subgroup I included 15 patients with salpingo-oophoritis, subgroup II included 10 patients with leiomyoma, subgroup III included 15 patients with benign ovarian cyst and subgroup IV included 30 patients with ovarian cancer. Serum progesterone and PIIINP were measured during follicular and luteal phases for control group. Serum amino-terminal propeptide of type III procollagen [PIIINP] and CA125 were measured preoperatively during follicular phase, using different immunochemical techniques for both controls and patients. The results revealed that levels of PIINP in healthy ovulating women were within the reference range [up to 6.7 mug/L]; however, there was significant rise in PIIINP during luteal phase compared to follicular phase [p <0.01]. There was positive correlation between PIIINP and progesterone in the luteal phase [r=0.95, p <0.001]. Levels of PIIINP were shown to be lowest in healthy women, intermediate in women with salpingo-oophoritis, in cases of leiomyoma and benign ovarian cysts, but significantly higher in cases with ovarian cancer. The sensitivity of PIIINP to predict ovarian cancer was 76.7% with specificity of 90.5% at a cut-off level of 55 mIU/ml. Using both PIIINP and CA125 the sensitivity went up to 92% and the specificity was 70%. In conclusion, PIIINP level is affected by ovarian hormones. There is positive correlation between serum PIIINP and progesterone in luteal phase in normal menstrual cycles. Preoperative estimation of amino-terminal propeptides of type III procollagen [PIIINP] is a good tool for detection of ovarian cancer and has a complementary value with CA125

Comparative study of the use of CA125, procollagen type III and the risk of malignancy index in diagnosis of ovarian cancer

This study included 140 women with ovarian mass for laparotomy. Serum was obtained preoperatively for measurement of CA125, amino-terminal propeptide of type III procollagen. Ultrasonography of the ovaries was performed and scored according to specific criteria. Main outcome measures the sensitivity, specificity of CA125, procollagen type III and the risk of malignancy index to differentiate between benign and malignant ovarian tumors. Using a cut-off level of 55 mIU/l for CA125 sensitivity was 83.3% and specificity was 88.9% and for procollagen type III using 11 ng/l as a cut-off level the sensitivity in detecting ovarian cancer was 76.7% with a specificity of 90.5%, while using a cut-off value of 200 the risk of malignancy index showed a sensitivity of 86.67% with specificity of 92.5%. In conclusion, although both CA125 and procollagen type III showed a reliable sensitivity for detecting ovarian cancer, the risk of malignancy index was superior in diagnosing ovarian cancer among patients with ovarian mass

Preoperative diagnosis of ovarian cancer in patients presented with adnexal mass using the risk of malignancy index

To detect ovarian cancer in patients presented with adnexal mass using Risk of Malignancy Index [RMI] based on menopausal status, ultrasound findings and serum level of CA125. Setting AI-Hussein University Hospital, Cairo- Egypt. Participants one hundred and forty women, 30 years or older, admitted with adnexal mass between September 1998 and February 2002, for laparotomy. Main Outcome Measures the sensitivity, specificity and positive predictive value of RMI based on menopausal status, ultrasound findings and serum CA 125 to diagnose ovarian cancer patients. Results using a cut-off level of 200 to indicate malignancy, the RMI gave sensitivity of 86.67%, specificity of 92.5% and positive predictive value of 89.66%. The risk of malignancy index is able to correctly discriminate between malignant and benign adnexal mass. It is highly recommended to be introduced into clinical practice in Egypt to facilitate the selection of patients for primary surgery at an Gynecologic Oncology Unit

Umbilical cord blood leptin, insulin -like growth factor-1, insulin -like growth factor binding protein-3 and newborn birth weight in pre-eclampsia

The aim of this study was to determine whether newborn birth weight is correlated to IGF-1, IGFBP-3 and leptin in cases with moderate preeclampsia. This study was done cross-sectionallly and included 25 pregnant women with moderate preeclampsia [PE group] and 25 normotensive pregnant women [NT group] of similar gestational age. Umbilical cord blood levels of IGF-1, IGFBP-3 and Leptin were assessed in each group. As compared with the NT group the PE group had significantly [p<0.001] lower newborn birth weight [3.33 [ +/- 0.9] vs 2.8 [ +/- 0.7] kg]], IGF-1 [66.5 [ +/- 26.7] vs 29.5 [ +/- 14.8] ng / ml] and IGFBP-3 [1250 [ +/- 39.94] vs 911 [ +/- 63.7] ng / ml]. Leptin was shown to be significantly [p<0.001] higher in the PE group compared with NT group. Significant correlation [r=0. 79, p<0.0001] was found between serum cord IGF and newborn birth weight, using stepwise multiple regression analysis, newborn birth weight was predicted by umbilical IGF-1 [r=0.53, p<0.0001]. A significant correlation between cord blood leptin and newborn birth weight was found only in the PE group r= 0.5 [p<0.01].No differences was found among female and male newborns regarding umbilical cord leptin concentration. The present study indicates that moderate preeclampsia is associated with low birth weight. IGF-1, IGFBP-3 and high leptin levels. There was a correlation between birth weight and IGF-1 which can predict newborn birth weight. Correlation between umbilical cord leptin and birth weight was found in cases with preeclampsia with no differences between leptin levels among female and male newborns