Tumor-associated autoantibodies as early detection markers for ovarian cancer? A prospective evaluation

Research output: Contribution to journalArticle


Immuno-proteomic screening has identified several tumor-associated autoantibodies (AAb) that may have diagnostic capacity for invasive epithelial ovarian cancer, with AAbs to P53 proteins and cancer-testis antigens (CTAGs) as prominent examples. However, the early detection potential of these AAbs has been insufficiently explored in prospective studies. We performed ELISA measurements of AAbs to CTAG1A, CTAG2, P53 and NUDT11 proteins, for 194 patients with ovarian cancer and 705 matched controls from the European EPIC cohort, using serum samples collected up to 36 months prior to diagnosis under usual care. CA125 was measured using electrochemo-luminiscence. Diagnostic discrimination statistics were calculated by strata of lead-time between blood collection and diagnosis. With lead times ≤6 months, ovarian cancer detection sensitivity at 0.98 specificity (SE98) varied from 0.19 [95% CI 0.08-0.40] for CTAG1A, CTAG2 and NUDT1 to 0.23 [0.10-0.44] for P53 (0.33 [0.11-0.68] for high-grade serous tumors). However, at longer lead-times, the ability of these AAb markers to distinguish future ovarian cancer cases from controls declined rapidly; at lead times >1 year, SE98 estimates were close to zero (all invasive cases, range: 0.01-0.11). Compared to CA125 alone, combined logistic regression scores of AAbs and CA125 did not improve detection sensitivity at equal level of specificity. The added value of these selected AAbs as markers for ovarian cancer beyond CA125 for early detection is therefore limited.


  • Rudolf Kaaks
  • Renée Turzanski Fortner
  • Anika Hüsing
  • Myrto Barrdahl
  • Marika Hopper
  • Theron Johnson
  • Anne Tjønneland
  • Louise Hansen
  • Kim Overvad
  • Agnès Fournier
  • Marie Christine Boutron-Ruault
  • Marina Kvaskoff
  • Laure Dossus
  • Mattias Johansson
  • Heiner Boeing
  • Antonia Trichopoulou
  • Vassiliki Benetou
  • Carlo La Vecchia
  • Sabina Sieri
  • Amalia Mattiello
  • Domenico Palli
  • Rosario Tumino
  • Giuseppe Matullo
  • N. Charlotte Onland-Moret
  • Inger T. Gram
  • Elisabete Weiderpass
  • Maria Jose Sánchez
  • Carmen Navarro Sanchez
  • Eric J. Duell
  • Eva Ardanaz
  • Nerea Larranaga
  • Eva Lundin
  • Annika Idahl
  • Ruth C. Travis
  • Elio Riboli
  • Melissa Merritt
  • Dagfinn Aune
  • Kathryn Terry
  • Daniel W. Cramer
  • Karen S. Anderson
External organisations
  • German Cancer Research Centre
  • Arizona State University
  • Danish Cancer Society Research Center
  • University of Paris-Sud
  • International Agency for Research on Cancer, World Health Organization
  • German Institute of Human Nutrition
  • National and Kapodistrian University of Athens
  • University of Milan
  • Istituto Nazionale dei Tumori
  • Citta' della Salute e della Scienza Hospital-University of Turin
  • University Medical Center Utrecht
  • UiT The Arctic University of Norway, Tromsø
  • Folkhälsan Research Center
  • Murcia Regional Health Council
  • Catalan Institute of Oncology
  • CIBERONC Centro de Investigación Biomédica en Red Cáncer
  • Umeå University
  • Skåne University Hospital
  • Imperial College London
  • Aarhus University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology


  • Antibodies, Early detection, Prospective validation
Original languageEnglish
Pages (from-to)515-526
JournalInternational Journal of Cancer
Issue number3
Early online date2018 Mar 8
Publication statusPublished - 2018
Publication categoryResearch