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Bérgamo S, Trapé J, González-García L, González-Fernández C, Vergara C, de-la-Torre N, Trujillo G, Estivill D, Álvarez-González MA, Bosch L, Otero-Viñas M, Bergós C, Catot S, Ruiz-Hidalgo D, Ros S, Sant F. Utility of human epididymis protein 4 in the differential diagnosis of ascites. Clin Biochem 2023; 120:110645. [PMID: 37696320 DOI: 10.1016/j.clinbiochem.2023.110645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND AND AIMS Human epididymal protein 4 (HE4) may be a useful tool in the differential diagnosis of malignant ascites. The aim of this study was to evaluate the diagnostic utility of HE4 for detecting malignant ascites, taking into account the possible false positives identified with adenosine deaminase (ADA), C-reactive protein (CRP), % polynuclear cells (%PMN) and glomerular filtration rate (eGFR). METHODS Concentrations of HE4, ADA, %PMN and CRP were determined in 114 samples of peritoneal fluid and creatinine in serum in order to calculate eGFR. RESULTS Concentrations of HE4 presented significant differences (P = 0.028) in benign [median (interquartile range)] [582(372)] pmol/L) and malignant ascites ([8241(367)] pmol/L. Sensitivity was 21.2% and specificity 100%. Significant differences were also observed for HE4 between tumors of gynecological origin ([3165(8769)] pmol/L) and others ([665(663)] pmol/L), with a sensitivity of 67% and a specificity of 100%. Classifying according to possible false positives (ADA > 45U/L, CRP > 50 mg/L, %PMN > 90 and eGFR < 30 mL/min/1.73 m2) at maximum specificity, a sensitivity of 33.3% was obtained for HE4, with a cut-off point of 2660 pmol/L. Without possible false positives (ADA < 45U/L, CRP < 50 mg/L, %PMN < 90 and eGFR ≥ 30 mL/min/1.73 m2), a sensitivity of 37.7% was obtained at 100% specificity for a cut-off point of 1041 pmol/L. Applying these criteria to the entire group, a sensitivity of 36.4% was obtained at maximum specificity. CONCLUSIONS HE4 allows the identification of malignant ascites with moderate sensitivity at maximum specificity. HE4 levels can differentiate between tumors of gynecological origin and others. Classification according to possible false positives increases sensitivity without losing specificity.
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Affiliation(s)
- Silvia Bérgamo
- Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària Manresa, Manresa, Catalonia, Spain; Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain; Doctoral School, University of Vic - Central University of Catalonia (UVic-UCC), Vic., Catalonia, Spain
| | - Jaume Trapé
- Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària Manresa, Manresa, Catalonia, Spain; Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain; Faculty of Medicine, University of Vic - Central University of Catalonia, Vic, Catalonia, Spain.
| | - Laura González-García
- Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària Manresa, Manresa, Catalonia, Spain; Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain
| | - Carolina González-Fernández
- Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària Manresa, Manresa, Catalonia, Spain; Gastrointestinal Oncology, Endoscopy and Surgery research group (GOES) Manresa. Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain
| | - Carme Vergara
- Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain; Department of Pathology, Althaia Xarxa Assistencial Universitària de Manresa. Manresa, Catalonia, Spain
| | - Noelia de-la-Torre
- Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain; Department of Pathology, Althaia Xarxa Assistencial Universitària de Manresa. Manresa, Catalonia, Spain
| | - Glòria Trujillo
- Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària Manresa, Manresa, Catalonia, Spain; Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain
| | - Dolors Estivill
- Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària Manresa, Manresa, Catalonia, Spain; Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain
| | - Marco Antonio Álvarez-González
- Gastrointestinal Oncology, Endoscopy and Surgery research group (GOES) Manresa. Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain; Department of Digestology, Althaia Xarxa Assistencial Universitària de Manresa. Manresa, Catalonia, Spain
| | - Laia Bosch
- Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain
| | - Marta Otero-Viñas
- Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain; Faculty of Science, Technology, and Engineering, University of Vic - Central University of Catalonia, Vic, Catalonia, Spain
| | - Carmen Bergós
- Department of Gynecology, Althaia Xarxa Assistencial Universitària de Manresa. Manresa, Catalonia, Spain
| | - Silvia Catot
- Department of Oncology, Althaia Xarxa Assistencial Universitària de Manresa. Manresa, Catalonia, Spain
| | - Domingo Ruiz-Hidalgo
- Department of Internal Medicine, Althaia Xarxa Assistencial Universitària Manresa. Manresa, Catalonia, Spain
| | - Sandra Ros
- Department of Pulmonary Diseases, Althaia Xarxa Assistencial Universitària de Manresa. Manresa, Catalonia, Spain
| | - Francesc Sant
- Tissue Repair and Regeneration Laboratory (TR2Lab), Institut de Recerca i Innovació en Ciències de la Vida i de la Salut a la Catalunya Central (IrisCC), 08500 Vic, Barcelona, Spain; Doctoral School, University of Vic - Central University of Catalonia (UVic-UCC), Vic., Catalonia, Spain; Department of Pathology, Althaia Xarxa Assistencial Universitària de Manresa. Manresa, Catalonia, Spain
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Wyatt KA, Filby CE, Davies-Tuck ML, Suke SG, Evans J, Gargett CE. Menstrual fluid endometrial stem/progenitor cell and supernatant protein content: cyclical variation and indicative range. Hum Reprod 2021; 36:2215-2229. [PMID: 34173001 DOI: 10.1093/humrep/deab156] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/20/2021] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION Does natural variation exist in the endometrial stem/progenitor cell and protein composition of menstrual fluid across menstrual cycles in women? SUMMARY ANSWER Limited variation exists in the percentage of some endometrial stem/progenitor cell types and abundance of selected proteins in menstrual fluid within and between a cohort of women. WHAT IS KNOWN ALREADY Menstrual fluid is a readily available biofluid that can represent the endometrial environment, containing endometrial stem/progenitor cells and protein factors. It is unknown whether there is natural variation in the cellular and protein content across menstrual cycles of individual women, which has significant implications for the use of menstrual fluid in research and clinical applications. STUDY DESIGN, SIZE, DURATION Menstrual fluid was collected from 11 non-pregnant females with regular menstrual cycles. Participants had not used hormonal medications in the previous 3 months. Participants collected menstrual fluid samples from up to five cycles using a silicone menstrual cup worn on Day 2 of menstrual bleeding. PARTICIPANTS/MATERIALS, SETTING, METHODS Menstrual fluid samples were centrifuged to separate soluble proteins and cells. Cells were depleted of red blood cells and CD45+ leucocytes. Menstrual fluid-derived endometrial stem/progenitor cells were characterized using multicolour flow cytometry including markers for endometrial stem/progenitor cells N-cadherin (NCAD) and stage-specific embryonic antigen-1 (SSEA-1) (for endometrial epithelial progenitor cells; eEPC), and sushi domain containing-2 (SUSD2) (for endometrial mesenchymal stem cells; eMSC). The clonogenicity of menstrual fluid-derived endometrial cells was assessed using colony forming unit assays. Menstrual fluid supernatant was analyzed using a custom magnetic Luminex assay. MAIN RESULTS AND THE ROLE OF CHANCE Endometrial stem/progenitor cells are shed in menstrual fluid and demonstrate clonogenic properties. The intraparticipant agreement for SUSD2+ menstrual fluid-derived eMSC (MF-eMSC), SSEA-1+ and NCAD+SSEA-1+ MF-eEPC, and stromal clonogenicity were moderate-good (intraclass correlation; ICC: 0.75, 0.56, 0.54 and 0.52, respectively), indicating limited variability across menstrual cycles. Endometrial inflammatory and repair proteins were detectable in menstrual fluid supernatant, with five of eight (63%) factors demonstrating moderate intraparticipant agreement (secretory leukocyte protein inhibitor (SLPI), lipocalin-2 (NGAL), lactoferrin, follistatin-like 1 (FSTL1), human epididymis protein-4 (HE4); ICC ranges: 0.57-0.69). Interparticipant variation was limited for healthy participants, with the exception of key outliers of which some had self-reported menstrual pathologies. LARGE SCALE DATA N/A. There are no OMICS or other data sets relevant to this study. LIMITATIONS, REASONS FOR CAUTION The main limitations to this research relate to the difficulty of obtaining menstrual fluid samples across multiple menstrual cycles in a consistent manner. Several participants could only donate across <3 cycles and the duration of wearing the menstrual cup varied between 4 and 6 h within and between women. Due to the limited sample size used in this study, wider studies involving multiple consecutive menstrual cycles and a larger cohort of women will be required to fully determine the normal range of endometrial stem/progenitor cell and supernatant protein content of menstrual fluid. Possibility for selection bias and true representation of the population of women should also be considered. WIDER IMPLICATIONS OF THE FINDINGS Menstrual fluid is a reliable source of endometrial stem/progenitor cells and related endometrial proteins with diagnostic potential. The present study indicates that a single menstrual sample may be sufficient in characterizing a variety of cellular and protein parameters across women's menstrual cycles. The results also demonstrate the potential of menstrual fluid for identifying endometrial and menstrual abnormalities in both research and clinical settings as a non-invasive method for assessing endometrial health. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by grants from the Australian National Health and Medical Research Council to C.E.G. (Senior Research Fellowship 1024298 and Investigator Fellowship 1173882) and to J.E. (project grant 1047756), the Monash IVF Research Foundation to C.E.G. and the Victorian Government's Operational Infrastructure Support Program. K.A.W., M.L.D.-T., S.G.S. and J.E. declare no conflicts of interest. C.E.G. reports grants from NHMRC, during the conduct of the study; grants from EndoFound USA, grants from Ferring Research Innovation, grants from United States Department of Defence, grants from Clue-Utopia Research Foundation, outside the submitted work. CEF reports grants from EndoFound USA, grants from Clue-Utopia Research Foundation, outside the submitted work.
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Affiliation(s)
- K A Wyatt
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, 3168 VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, 3168 VIC, Australia
| | - C E Filby
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, 3168 VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, 3168 VIC, Australia
| | - M L Davies-Tuck
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, 3168 VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, 3168 VIC, Australia
| | - S G Suke
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, 3168 VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, 3168 VIC, Australia
| | - J Evans
- Department of Obstetrics and Gynaecology, Monash University, Clayton, 3168 VIC, Australia.,Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, 3168 VIC, Australia
| | - C E Gargett
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, 3168 VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, 3168 VIC, Australia
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Miao R, Badger TC, Groesch K, Diaz-Sylvester PL, Wilson T, Ghareeb A, Martin JA, Cregger M, Welge M, Bushell C, Auvil L, Zhu R, Brard L, Braundmeier-Fleming A. Assessment of peritoneal microbial features and tumor marker levels as potential diagnostic tools for ovarian cancer. PLoS One 2020; 15:e0227707. [PMID: 31917801 PMCID: PMC6952086 DOI: 10.1371/journal.pone.0227707] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/26/2019] [Indexed: 12/15/2022] Open
Abstract
Epithelial ovarian cancer (OC) is the most deadly cancer of the female reproductive system. To date, there is no effective screening method for early detection of OC and current diagnostic armamentarium may include sonographic grading of the tumor and analyzing serum levels of tumor markers, Cancer Antigen 125 (CA-125) and Human epididymis protein 4 (HE4). Microorganisms (bacterial, archaeal, and fungal cells) residing in mucosal tissues including the gastrointestinal and urogenital tracts can be altered by different disease states, and these shifts in microbial dynamics may help to diagnose disease states. We hypothesized that the peritoneal microbial environment was altered in patients with OC and that inclusion of selected peritoneal microbial features with current clinical features into prediction analyses will improve detection accuracy of patients with OC. Blood and peritoneal fluid were collected from consented patients that had sonography confirmed adnexal masses and were being seen at SIU School of Medicine Simmons Cancer Institute. Blood was processed and serum HE4 and CA-125 were measured. Peritoneal fluid was collected at the time of surgery and processed for Next Generation Sequencing (NGS) using 16S V4 exon bacterial primers and bioinformatics analyses. We found that patients with OC had a unique peritoneal microbial profile compared to patients with a benign mass. Using ensemble modeling and machine learning pathways, we identified 18 microbial features that were highly specific to OC pathology. Prediction analyses confirmed that inclusion of microbial features with serum tumor marker levels and control features (patient age and BMI) improved diagnostic accuracy compared to currently used models. We conclude that OC pathogenesis alters the peritoneal microbial environment and that these unique microbial features are important for accurate diagnosis of OC. Our study warrants further analyses of the importance of microbial features in regards to oncological diagnostics and possible prognostic and interventional medicine.
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Affiliation(s)
- Ruizhong Miao
- Department of Statistics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Taylor C. Badger
- Department of Medical Microbiology, Immunology and Cell Biology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Kathleen Groesch
- Center for Clinical Research, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Paula L. Diaz-Sylvester
- Center for Clinical Research, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Teresa Wilson
- Center for Clinical Research, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Allen Ghareeb
- Center for Clinical Research, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Jongjin Anne Martin
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Melissa Cregger
- Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States of America
- Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Michael Welge
- National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Colleen Bushell
- Applied Research Institute, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Loretta Auvil
- National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Ruoqing Zhu
- Department of Statistics, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Laurent Brard
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
- Simmons Cancer Institute at SIU, Springfield, Illinois, United States of America
| | - Andrea Braundmeier-Fleming
- Department of Medical Microbiology, Immunology and Cell Biology, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
- Simmons Cancer Institute at SIU, Springfield, Illinois, United States of America
- * E-mail:
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4
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Liu D, Kong D, Li J, Gao L, Wu D, Liu Y, Yang W, Zhang L, Zhu J, Jin X. HE4 level in ascites may assess the ovarian cancer chemotherapeutic effect. J Ovarian Res 2018; 11:47. [PMID: 29903044 PMCID: PMC6002981 DOI: 10.1186/s13048-018-0402-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/26/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The clinical treatment of ovarian cancer with ascites is problematic. The main reasons for treatment failure are the susceptibility to intraperitoneal metastasis and chemotherapeutic drug resistance. The purpose and significance of this study is to evaluate which marker might evaluate treatment efficacy and improve the cure rate. RESULTS This study compared a no chemotherapy group with a chemotherapy group regarding the determination of carbohydrate antigen 125 and human epididymis protein 4 in ovarian cancer ascitic supernatants and cross-analyzed routine serum carbohydrate antigen 125 levels. The level of human epididymis protein 4 in the ascites of the chemotherapy group was significantly lower than that of the no chemotherapy group (p < 0.001). Moreover, the expression of ascitic human epididymis protein 4 correlated positively with serum carbohydrate antigen 125 levels (p < 0.001). MDR was positive in 13 of the 30 samples (43.33%) in the chemotherapy group with highly expressed CA125. CONCLUSION The level of human epididymis protein 4 in ovarian cancer ascites may reflect the therapeutic effect of ovarian cancer patients, and a high level of human epididymis protein 4 might predict chemoresistance and the possibility of ascites formation. The determination of the expression of human epididymis protein 4 alone or combined with carbohydrate antigen 125 levels in both serum and ascites in ovarian cancer patients with ascites may have important significance for guiding and improving the treatment regimen.
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Affiliation(s)
- Duanyang Liu
- Department of Pathology, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, China
| | - Dan Kong
- Department of Oncologic Gynecology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Jing Li
- Department of Pathology, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, China
| | - Lei Gao
- Department of Pathology, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, China
| | - Di Wu
- Department of Gynecology, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yu Liu
- Department of Pathology, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, China
| | - Weiwei Yang
- Department of Pathology, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, China
| | - Lei Zhang
- Department of Pathology, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, China
| | - Jiang Zhu
- Department of Orthopedics, the First Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Xiaoming Jin
- Department of Pathology, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, China.
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Williams RM, Lee C, Galassi TV, Harvey JD, Leicher R, Sirenko M, Dorso MA, Shah J, Olvera N, Dao F, Levine DA, Heller DA. Noninvasive ovarian cancer biomarker detection via an optical nanosensor implant. SCIENCE ADVANCES 2018; 4:eaaq1090. [PMID: 29675469 PMCID: PMC5906074 DOI: 10.1126/sciadv.aaq1090] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 03/06/2018] [Indexed: 05/20/2023]
Abstract
Patients with high-grade serous ovarian carcinoma (HGSC) exhibit poor 5-year survival rates, which may be significantly improved by early-stage detection. The U.S. Food and Drug Administration-approved biomarkers for HGSC-CA-125 (cancer antigen 125) and HE4 (human epididymis protein 4)-do not generally appear at detectable levels in the serum until advanced stages of the disease. An implantable device placed proximal to disease sites, such as in or near the fallopian tube, ovary, uterine cavity, or peritoneal cavity, may constitute a feasible strategy to improve detection of HGSC. We engineered a prototype optical sensor composed of an antibody-functionalized carbon nanotube complex, which responds quantitatively to HE4 via modulation of the nanotube optical bandgap. The complexes measured HE4 with nanomolar sensitivity to differentiate disease from benign patient biofluids. The sensors were implanted into four models of ovarian cancer, within a semipermeable membrane, enabling the optical detection of HE4 within the live animals. We present the first in vivo optical nanosensor capable of noninvasive cancer biomarker detection in orthotopic models of disease.
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Affiliation(s)
| | - Christopher Lee
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Thomas V. Galassi
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Weill Cornell Medicine, Cornell University, New York, NY 10065, USA
| | - Jackson D. Harvey
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Weill Cornell Medicine, Cornell University, New York, NY 10065, USA
| | - Rachel Leicher
- Tri-Institutional Program in Chemical Biology, New York, NY 10065, USA
- The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA
| | - Maria Sirenko
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Madeline A. Dorso
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Weill Cornell Medicine, Cornell University, New York, NY 10065, USA
| | - Janki Shah
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Narciso Olvera
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY 10016, USA
| | - Fanny Dao
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY 10016, USA
| | - Douglas A. Levine
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY 10016, USA
| | - Daniel A. Heller
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Weill Cornell Medicine, Cornell University, New York, NY 10065, USA
- Corresponding author.
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