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@ARTICLE{Fortner:132470,
      author       = {R. T. Fortner$^*$ and H. Schock$^*$ and C. Le Cornet$^*$
                      and A. Hüsing$^*$ and A. F. Vitonis and T. S. Johnson and
                      R. N. Fichorova and T. Fashemi and H. S. Yamamoto and A.
                      Tjønneland and L. Hansen and K. Overvad and M.-C.
                      Boutron-Ruault and M. Kvaskoff and G. Severi and H. Boeing
                      and A. Trichopoulou and E.-M. Papatesta and C. La Vecchia
                      and D. Palli and S. Sieri and R. Tumino and C. Sacerdote and
                      A. Mattiello and N. C. Onland-Moret and P. H. Peeters and H.
                      B. A. Bueno-de-Mesquita and E. Weiderpass and J. R. Quirós
                      and E. J. Duell and M.-J. Sánchez and C. Navarro and E.
                      Ardanaz and N. Larrañaga and B. Nodin and K. Jirström and
                      A. Idahl and E. Lundin and K.-T. Khaw and R. C. Travis and
                      M. Gunter and M. Johansson and L. Dossus and M. A. Merritt
                      and E. Riboli and K. L. Terry and D. W. Cramer and R.
                      Kaaks$^*$},
      title        = {{O}varian cancer early detection by circulating {CA}125 in
                      the context of anti-{CA}125 autoantibody levels: {R}esults
                      from the {EPIC} cohort.},
      journal      = {International journal of cancer},
      volume       = {142},
      number       = {7},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2018-00158},
      pages        = {1355 - 1360},
      year         = {2018},
      abstract     = {CA125 is the best ovarian cancer early detection marker to
                      date; however, sensitivity is limited and complementary
                      markers are required to improve discrimination between
                      ovarian cancer cases and non-cases. Anti-CA125
                      autoantibodies are observed in circulation. Our objective
                      was to evaluate whether these antibodies (1) can serve as
                      early detection markers, providing evidence of an immune
                      response to a developing tumor, and (2) modify the
                      discriminatory capacity of CA125 by either masking CA125
                      levels (resulting in lower discrimination) or acting
                      synergistically to improve discrimination between cases and
                      non-cases. We investigated these objectives using a nested
                      case-control study within the European Prospective
                      Investigation into Cancer and Nutrition cohort (EPIC)
                      including 250 cases diagnosed within 4 years of blood
                      collection and up to four matched controls. Circulating
                      CA125 antigen and antibody levels were quantified using an
                      electrochemiluminescence assay. Adjusted areas under the
                      curve (aAUCs) by 2-year lag-time intervals were calculated
                      using conditional logistic regression calibrated toward the
                      absolute risk estimates from a pre-existing epidemiological
                      risk model as an offset-variable. Anti-CA125 levels alone
                      did not discriminate cases from controls. For cases
                      diagnosed <2 years after blood collection, discrimination by
                      CA125 antigen was suggestively higher with higher anti-CA125
                      levels (aAUC, highest antibody tertile: 0.84 [0.76-0.92];
                      lowest tertile: 0.76 [0.67-0.86]; phet = 0.06). We
                      provide the first evidence of potentially synergistic
                      discrimination effects of CA125 and anti-CA125 antibodies in
                      ovarian early detection. If these findings are replicated,
                      evaluating CA125 in the context of its antibody may improve
                      ovarian cancer early detection.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29159934},
      pmc          = {pmc:PMC5805613},
      doi          = {10.1002/ijc.31164},
      url          = {https://inrepo02.dkfz.de/record/132470},
}