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.

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.

• Authors: Anniina Färkkilä, Sanna Koskela, Saara Bryk, Henrik Alfthan, Ralf Bützow, Arto Leminen, Ulla Puistola, Juha S Tapanainen, Markku Heikinheimo, Mikko Anttonen, Leila Unkila-Kallio
• Journal: International journal of cancer (Int J Cancer) Vol. 137 Issue 7 Pg. 1661-71 (Oct 01 2015) ISSN: 1097-0215 [Electronic] United States
• PMID: 25808251 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 UICC.

Chemical References

• Biomarkers, Tumor
• inhibin B
• Inhibins
• Anti-Mullerian Hormone

Topics

• Adult
• Aged
• Anti-Mullerian Hormone (blood)
• Biomarkers, Tumor (blood)
• Cohort Studies
• Female
• Follow-Up Studies
• Granulosa Cell Tumor (blood)
• Humans
• Inhibins (blood)
• Longitudinal Studies
• Middle Aged
• Ovarian Neoplasms (blood)
• Young Adult