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Int J Cancer. 2015 Oct 1;137(7):1661-71. doi: 10.1002/ijc.29532. Epub 2015 Apr 11.

The clinical utility of serum anti-Müllerian hormone in the follow-up of ovarian adult-type granulosa cell tumors--A comparative study with inhibin B.

Author information

1
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
2
Department of Pediatrics, University of Helsinki, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
3
Department of Obstetrics and Gynecology, University of Oulu, Oulu University Hospital and Medical Research Center Oulu, Oulu, Finland.
4
Department of Clinical Chemistry, University of Helsinki and HUSlab, Helsinki University Central Hospital, Helsinki, Finland.
5
Department of Pathology, University of Helsinki and HUSlab, Helsinki University Central Hospital, Helsinki, Finland.
6
Department of Pediatrics, Washington University School of Medicine, St Louis Children's Hospital, St Louis, MO.

Abstract

Ovarian adult-type granulosa cell tumors (AGCTs) require prolonged follow-up, but evidence regarding the optimal follow-up marker is lacking. The objective of our study was to validate the clinical usefulness of serum anti-Müllerian hormone (AMH) and the current marker inhibin B as single and combined markers of AGCTs. We conducted a longitudinal, partially prospective cohort study of 123 premenopausal and postmenopausal AGCT patients with a median follow-up time of 10.5 years (range 0.3-50.0 years). Serum AMH and inhibin B levels were measured from 560 pretreatment and follow-up serum samples by using immunoenzymometric assays. We found that serum AMH and inhibin B levels were significantly elevated in patients with primary or recurrent AGCTs. The levels of both markers positively correlated to tumor size (p < 0.05). AMH and inhibin B performed similarly in receiving operator characteristic analyses; area under the curve (AUC) values were 0.92 [95% confidence interval (CI) 0.88-0.95] for AMH, and 0.94 (95% CI 0.90-0.96) for inhibin B. AMH was highly sensitive (92%) and specific (81%) in detecting a macroscopic AGCT. However, in AUC comparison analyses, the combination of the markers was superior to inhibin B alone. In conclusion, serum AMH is a sensitive and specific marker of AGCT, and either AMH or inhibin B can be monitored during follow-up. However, combining AMH and inhibin B in AGCT patient follow-up improves the detection of recurrent disease.

KEYWORDS:

anti-Müllerian hormone; granulosa cell tumor; inhibin B; ovarian cancer; serum marker

PMID:
25808251
DOI:
10.1002/ijc.29532
[Indexed for MEDLINE]
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