Molecular Signals in the Blood: A Perspective on the Early Detection of Ovarian Cancer
Blood test identifies a molecular marker of developing ovarian cancer before invasive cancer develops
ovarian cancer is usually not diagnosed until an invasive tumor has already formed. Early stages of tumor development are difficult to detect and are typically identified only through biopsies. An international research team, including a scientist from Justus Liebig University Giessen (JLU), has now identified a signaling molecule in the blood that can identify women with microscopic, non-invasive changes in the fallopian tubes. These changes are precancerous lesions that can develop into aggressive ovarian cancer over time. Detection of this signaling molecule opens up the possibility of detecting the disease at a much earlier stage—even before the cancer has spread to surrounding tissue. The findings have been published in the journal *Nature Medicine*.
Many aggressive ovarian cancers do not originate in the ovary itself, but in the fallopian tube. In their earliest detectable stage, these changes consist of a small cluster of abnormal cells confined to the inner lining of the fallopian tube. This condition is known as serous tubal intraepithelial carcinoma (STIC). The key difference from actual cancer cells is that the abnormal cells have not yet invaded the surrounding tissue. The microscopic lesions therefore generally do not cause any noticeable symptoms and are too small to be visible in routine imaging tests. They are most often discovered when removed fallopian tubes are examined under a microscope. The study’s findings suggest that these early changes may precede invasive ovarian cancer by several years, thereby opening up a valuable window of opportunity for early detection and intervention.
“We often think of cancer as a tumor that starts small and then simply grows,” says Dr. Jochen Wilhelm of the Platform for Genomics and Bioinformatics at the Institute for Lung Health (ILH) at JLU, the first author of the study conducted by a large international consortium led by researchers from the U.S. “But invasive ovarian cancer is preceded by developmental stages of cells that are still significantly different from the later tumor cells. These earliest stages can be completely invisible in imaging procedures. We wanted to find out whether the body might carry a molecular warning sign long before an invasive tumor becomes visible.”
Molecular Message in the Blood
The researchers investigated an RNA molecule called Tu-Stroma—a signaling molecule sent from the tumor (“Tu”) into the surrounding tissue (“Stroma”). This molecule is involved in communication between cancer cells and the healthy tissue around them. It prepares the way for subsequent cancer cell invasion by programming the surrounding cells to make room for the expanding tumor cells. The study showed that this molecular signal was already present in the blood of women with microscopic STIC lesions. The researchers tested blood samples from 506 women, including 43 with confirmed isolated STIC.
In an independent validation group within the study, the blood test identified 24 out of 26 women with STIC (92.3%) and correctly classified 53 out of 54 healthy controls (98.2%). “It is noteworthy that the signal was already elevated at this early, noninvasive stage and did not increase steadily as ovarian cancer progressed,” said Dr. Wilhelm. “This is to be expected if the test detects an early biological process associated with cancer development, rather than simply measuring the size of an existing tumor.”
The researchers also performed the routine screening test for ovarian cancer—which is based on measuring the so-called CA125 marker in the blood—on the samples. “Using this standard clinical screening test, we were unable to identify a single sample with STIC,” says Dr. Wilhelm. “Even in early, already invasive stages, this screening performed significantly worse than the new blood test.”
A New Perspective on Women’s Health
A reliable method for identifying microscopic changes could be particularly important for women with an increased hereditary risk of ovarian cancer, including carriers of the BRCA1 or BRCA2 mutations associated with breast cancer. It would help women and their doctors make more informed decisions about cancer prevention, monitoring, and interventions in the future.
However, before the test can be used for routine screenings, further prospective clinical trials are needed. For example, the study has not yet clarified how many years in advance the test can provide a warning or whether its use improves survival rates.
Note: This article has been translated using a computer system without human intervention. LUMITOS offers these automatic translations to present a wider range of current news. Since this article has been translated with automatic translation, it is possible that it contains errors in vocabulary, syntax or grammar. The original article in German can be found here.
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Topic world Diagnostics
Diagnostics is at the heart of modern medicine and forms a crucial interface between research and patient care in the biotech and pharmaceutical industries. It not only enables early detection and monitoring of disease, but also plays a central role in individualized medicine by enabling targeted therapies based on an individual's genetic and molecular signature.
Topic world Diagnostics
Diagnostics is at the heart of modern medicine and forms a crucial interface between research and patient care in the biotech and pharmaceutical industries. It not only enables early detection and monitoring of disease, but also plays a central role in individualized medicine by enabling targeted therapies based on an individual's genetic and molecular signature.