Validation and Characterization of Human Kallikrein 11 as a Serum Marker for Diagnosis of Ovarian Carcinoma

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Abstract
Purpose: The serum tumor marker CA 125 is elevated in most clinically advanced ovarian carcinomas, and currently, one of the most promising early detection strategies for ovarian cancer uses CA 125 level in conjunction with imaging. However, CA 125 is elevated in only 50% of early-stage ovarian cancer and is often elevated in women with benign ovarian tumors and other gynecologic diseases. Additional markers may improve on its individual performance if they increase sensitivity and specificity and are less sensitive to other gynecologic conditions. The human kallikrein 11 (hK11) marker has been reported to have favorable predictive value for ovarian cancer, although, by itself, it may be inferior to CA 125. Experimental Design: We here validate the performance of hK11 on an independent data set and further characterize its behavior in multiple types of controls. We also investigate its behavior when combined with CA 125 to form a composite marker. hK11 had not previously been evaluated on these serum samples. CA 125, hK11, and the composite marker were evaluated for their performance in identifying ovarian cancer and for temporal stability. Results: hK11 significantly distinguished ovarian cancer cases from healthy controls and is less sensitive to benign ovarian disease than is CA 125. Conclusion: We conclude that hK11 is a valuable new biomarker for ovarian cancer and its temporal stability implies that it may do even better when used in a longitudinal screening program for early detection.