| Background and ObjectiveAs the most common cause of mortality from gynecological cancers，ovariancance is usually incurable.Owing to atypical clinical symptoms and insufficientscreening of available biomarkers,70%patients have wide metastasis at a late stageat the time of diagnosis. Ovarian cancer is an extremely aggressive tumor, highlyresistant to chemotherapy and a5year survival rate only at20-30%even ifchemotherapy therapy is delivered after surgical treatment. Significant advancementsin ovarian cancer treatment will depend highly onan early diagnosis. Serum tumormarkers offers important hints in the initial diagnosis of ovarian cancer, evaluation ofcurative effect and judgment of prognosis. But the specificity and sensitivity may berelatively low. Therefore, it is essential to explore novel biomarkers with highersensitivity and specificity for the diagnosis of malignancy. Immediate early responsegenes (immediate early response gene X-1, IEX-1)，plays an important role in theregulation of cell proliferation,apoptosis and differentiation. Depending on the tumortype and stage of the cancer, the abnormal expression of IEX–1is closely related toeither poor or better prognosis of the variety cancer. In our model, IEX-1was foundto be significantly down-regulated in epithelial ovarian tumors. This finding suggeststhat IEX-1may be involved in the suppression of epithelial ovarian carcinoma development. Further, its level of expression may serve as a specific marker ofovarian carcinoma and/or can be used to identify the disease at a relatively early stage.In clinic practice, blood based diagnostic assays are the most widely applied fortumor markers; with advantages of easy procedures, high sensitivity andcost-effectiveness. Saliva based diagnostic assay is presently at a mature juncture ofbeing evaluated as a means of detecting ovarian cancer. These will make it possible touse saliva as a specimen in the diagnosis of ovarian cancer. In this paper, differentexpression and diagnostic values of IEX-1in blood and saliva were validated usingRT-qPCR.MethodsAll the blood and saliva samples were obtained from pelvic mass patients whowere divided into epithelial ovarian carcinoma and benign ovarian diseases group.The control individuals were healthy women. IEX-1mRNA was isolated and detectedby real-time fluorescent quantitative reverse transcription polymerase chainreaction(RT-qPCR). The receiver operating characteristic (ROC)curve was used toevaluate the diagnostic efficacy, sensitivity and specificity of IEX-1in blood andsaliva.Results1．In comparison with ovarian carcinoma group, relative IEX-1expression inblood was1.81±0.31higher in benign ovarian diseases group or1.72±0.32timeshigher in healthy women group. Relative IEX-1expression in saliva in benignovarian diseases group and healthy women group were1.67±0.37and1.80±0.40times higher than in ovarian carcinoma group, respectively. The differences in IEX-1expression in blood and saliva were both statistically significant (p<0.017). However,there was no significant difference in IEX-1expression between benign ovariandiseases group and healthy women group both in blood and saliva.（p>0.017,respectively)2. In blood, when compared ovarian carcinoma group with benign ovariandiseases group or healthy women group, the receiver operating characteristic area under curves (ROC-AUCs) were0.947and0.929, respectively. The expression levelof IEX-1helped to discriminate ovarian carcinoma group from benign ovariandiseases group with a sensitivity and specificity of84.6%and94.6%, respectively.And the panel also provided84.6%sensitivity and90.9%specificity in distinguishingovarian carcinoma group from healthy women group.3. In saliva, when compared ovarian carcinoma group with. benign ovariandiseases group or healthy women group, ROC-AUCs were0.851and0.896,respectively. The expression level of IEX-1helped to discriminate ovarian carcinomagroup from benign ovarian diseases group with a sensitivity and specificity of65.4%and94.6%, respectively. And the panel also provided92.3%sensitivity and72.5%specificity in distinguishing ovarian carcinoma from healthy women.Conclusion1. These findings demonstrate high quantity and quality of isolated salivarymRNA to ensure the sufficiency and accuracy for RT-qPCR;2. In ovarian cancer，the diagnostic value of IEX-1is high in blood and mediumin saliva;3.For characteristics of non-invasive and collect conveniently,saliva alsosuggest a new sample for detection of epithelial ovarian carcinoma. |
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