Table 1.

Polyamine as biomarkers for ovarian cancer.

Polyamines	Sources of Polyamines	Observations	Reference
Polyamines	Urine	Increased polyamines correlate with clinical status.	[221]
Free and acetylated polyamines	Urine	Free and acetylated polyamines were elevated in cases compared to controls.	[222]
Putrescine Spermidine Spermine	Urine	Polyamines are elevated in patients with progressive diseases; Spermidine/creatinine ratio is increased.	[223]
Putrescine Spermidine Spermine NAcPuT AcSpmd	Urine	Polyamines are drastically elevated in cancer patients	[224]
DAS	Urine	DAS has 65% specificity and 91% sensitivity (AUC 0.82), better than CA-125 (65% specificity, 68% sensitivity, AUC 0.75) and RMI (70% specificity, 68% sensitivity, AUC 0.72)	[225]
DAS N3AP DAS AcSpmd	Plasma	Polyamine signature consisting of DAS and N3AP in combination with CA-125 yields improvement in sensitivity at >99% specificity relative to CA-125 alone (73.7% vs. 62.2%) and can capture 30.4% more cases than CA-125 alone	[22]
DAS N3AP DiAcSpmd	Serum	7MetP yields an AUC of 0.86; 7MetP+ROMA increase AUC from 0.91 (ROMA alone) to 0.93; 7MetP+ROMA has a higher positive predictive value (0.68 vs. 0.52) with improved specificity (0.89 vs. 0.78) compared to ROMA alone.	[220]

DAS: Diacetylspermine, NAcPut: N-acetylputrescine, AcSpmd: N-acetylspermidine, N3AP: N-(3-acetamidopropyl)pyrrolidine-2-one, DiAcSpmd: Diacetylspermidine, 7MetP: 7-marker metabolite panel, ROMA: risk of ovarian malignancy algorithm.