Table 1.

Novel tumor biochemical markers for early detection of ovarian cancer.

Biochemical marker	Nature	Origin/function	Status	Source	Clinical utility	References
CA125	Glycoprotein antigen	Expressed by fetal amniotic epithelium and coelomic epithelium	Elevated Early stage: 47% Advanced stage: >90%	Serum	Valuable marker for tumor recurrence Limitations: Unsuitable for early detection due to insufficient sensitivity and being elevated in other conditions	Clarke-Pearson, 2009; Moore et al., 2010
HE4	Protease	Serum maturation	Elevated Serous: 93% Endometrioid: 100%	Serum	Histotype differentiation and screening	Hough et al., 2000; Lu et al., 2004; Moore et al., 2008
Mesothelin	Glycosylphosphatidylinositol- linked cell surface molecule	*Expressed by mesothelial cells *Involved in metastasis	Elevated Early stage: 60%	Urine	Early screening	McIntosh et al., 2004; Tang et al., 2013
Transthyretin	An acute phase reactant and major carrier of serum thyroxine	Tumor development	Downregulated in EOC patients	Serum	Early stage screening	Mählck and Grankvist, 1994; Schweigert and Sehouli, 2005; Nosov et al., 2009
ApoA1	Constituent of high density lipoproteins	Prevents tumor development	Downregulated in ovarian cancer patients	Serum	Early stage screening	Gadomska et al., 2005; Kim et al., 2012
Kallikrein	Family of Serine proteases *Human KLK family: 15 members *Chromosome position: 19q13.3–4	Regulates proteolytic cascades	Elevated: 12KLK/15	Serum	Elevated KLK-6 and−10 in OC cases with low level of CA125. Useful marker for OC detection	Borgoño and Diamandis, 2004; Rosen et al., 2005
Osteopontin	An adhesive glycoprotein	*Synthesized by osteoblasts and vascular endothelial cells *Associated with bone remodeling and immune function	Elevated in invasive and borderline ovarian cancer tumors	Plasma	Early stage screening	Kim et al., 2002